Conditions
GOUT
SymptomsGout is a very painful form of arthritis that can develop when blood levels of uric acid are very high. Uric acid is a substance that normally forms when the body breaks down substances called purines, which are found in the body and consumed in foods.
This build up of uric acid can lead to the development of sharp, needle-like crystals, which can accumulate in the body’s connective tissues. These deposits of uric acid crystals produce swelling, redness, heat, pain and stiffness in the joints.
The symptoms of gout are usually severe and can occur without warning, often at night. Such occurrences are called acute gouty arthritis. Symptoms include inflammation, redness and severe joint pain. The small joint at the base of the big toe is the most common site of an acute gout attack. Other joints that can be affected include the ankles, knees, wrists, fingers, and elbows. Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness.
Causes
In most cases, gout is caused when the blood contains raised levels of uric acid sustained over long periods. The kidneys process uric acid and excrete this through urine. When uric acid levels increase, the kidneys are unable to eliminate uric acid efficiently. In some cases, the cause of gout is linked to kidney disease. Blood uric acid levels can arise when the kidney is not functioning properly.
When the body is unable to eliminate uric acid, deposits of a hardened crystallised form of uric acid (tophi) usually form in the joints and skin. Within the joints, deposits can be made in the joint fluid (synovial fluid) and joint lining (synovial lining). Common areas for these deposits are the ankles, feet and ball of the large toe.
Additionally, the tendency towards developing gout also seems to be significantly influenced by the metabolism a person inherits.
How to treat it
Preventing acute gout attacks is equally as important as treating the condition. Prevention of acute gout involves maintaining adequate fluid intake, weight management, dietary changes, reduction in alcohol consumption, and medications to reduce hyperuricemia.
Maintaining adequate fluid intake helps prevent acute gout attacks, and also decreases the risk of kidney stone formation in patients with gout. Alcohol can also affect uric acid metabolism by slowing down the excretion of uric acid from the kidneys as well as by causing dehydration, which precipitates the crystals in the joints.
There are three aspects to the medication treatment of gout: first, pain relievers such as Paracetemol or other more potent analgesics to manage pain. Secondly, anti-inflammatory agents such as nonsteroidal anti-inflammatory drugs (NSAIDS) and corticosteroids to decrease joint inflammation. And finally, medications that are considered for managing the underlying metabolic derangement that causes hyperuricemia and gout. Check with your doctor to discuss what pain relief medication is best for you.
Getting a correct diagnosis and working with your doctor and other health professionals to design the best treatment plan is essential. Your treatment program will take into consideration the nature of your symptoms, your age, occupation and lifestyle interests.
Lifestyle considerations
Weight management can be helpful in lowering the risk of recurrent attacks of gout. This is best accomplished by reducing dietary fat and calorie intake, combined with a regular aerobic exercise program. Exercise also stimulates the release of endorphins (adrenaline) which are your body's own natural pain relievers.
Activities such as walking, cycling and swimming are all excellent. These activities are low-impact, so they minimise the stress on your joints. They also make your heart, lungs and muscles more efficient and boost your immune system function. Aerobic exercise really is the key to good health.
Please contact your doctor to develop your personal gout plan. Your doctor can provide expert advice regarding safe participation in exercise and a healthy lifestyle to complement your medications treatment.
Your doctor can help design your lifestyle program and provide referrals to other health professionals. This website also contains some excellent resources, so take some time to browse. Your local Pharmacist is an excellent source of information about gout and appropriate medications that may be helpful in your treatment.
Sourced from:
www.medicinenet.com
www.niams.nih.gov
www.betterhealth.vic.gov.au
www.epodiatry.com
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