Gout Symptoms and Treatments

What is gout?

A lesser known form of arthritis is gout. It is an inflammatory disease caused by buildup of uric acid crystals in the joints. Hyperuricemia, an elevated blood level of uric acid, is a result of the liver producing more uric acid than the body can excrete in the urine, or when a diet high in rich foods produces more uric acid than the kidneys can filter from the blood.

Eventually, sharp crystals form from the excess uric acid and settle in joints, causing inflammation, stiffness, swelling, and pain. Quite often, the big toe is the first area gout appears. Even if it doesn't strike the big toe first, it will eventually appear there in almost all cases. Other areas frequently affected are fingers, wrists, elbows, knees, ankles, heals, and instep. Your hips, shoulders, and spine are rarely affected.

Signs and Symptoms

Symptoms develop very quickly and are usually limited to one joint at a time. A painful big toe may be the first sign:

• pain
• inflammation
• redness
• stiffness
• swelling

Moving or touching the affected joint may be extremely painful. Many gout sufferers report that having even a bed sheet touch the joint (especially the big toe) can be excrutiating. The joint is warm to the touch, and swelling produces a shiny, tight, reddish or purplish tint to the skin. In some cases, there's a general blah feeling along with fever, chills and a rapid heart beat.

If several joints are affected at once, it's probably not gout. The initial flare-up will eventually go away after 7-10 days. Your first attack may be your last without lingering affects. Or, the attacks may increase in frequency and duration and evolve into painful chronic gout. If left untreated, gout can damage the joints and result in disability.

Causes

Over 2 million Americans suffer from gout, the majority of them men. Uric acid levels are lower in women, until menopause. The levels begin to rise once a woman reaches menopause, but it can take up to 20 years for levels to be equal to male levels. The following can lead to gout:

• family history--6 to 18 percent of those with the disease have a history of it in their family
• diet--large amounts of purines in your diet can stimulate your body's production of uric acid (foods high in purines: organ meats and other meats, dried beans and peas, anchovies, herring, mackerel, and gravies.)
• drinking too much alcohol can interfere with kidney function(if you're having an attack, avoid alcohol completely because it can interfere with the removal of uric acid from your body)
• blood cancer or diseases that result in higher levels of uric acid through rapid multiplication and destruction of cells
• diseases that affect your kidneys' ability to filter out uric acid

Gout is also associated with high blood pressure, obesity, and high levels of blood fats.

Diagnosing Gout

Blood tests will determine the level of uric acid in your blood. Your doctor will also take a fluid sample from the afflicted joint. A microscopic examination of the fluid will check for the presence of uric acid crystals. If crystals are present, the probable diagnosis is gout.

Treatment

There is no cure, but medications and lifestyle changes can help. The goal is to reduce the uric acid levels that are responsible for uric acid crystals in your joint(s). In many cases, if gout is not a recurring problem, it isn't treated. But if it is an ongoing problem, not treating it may lead to damaged joints and disability.

Treatment can include high doses of anti-inflammatories (NSAIDs) for pain and inflammation. Over-the-counter NSAIDs (e.g.,ibuprofen, Anacin) are less powerful but generally have less side effects than prescription NSAIDs (e.g.,naproxen, indomethacin). Their are other medications that your doctore may prescribe to you. NSAIDs should only be used as instructed.

Corticosteroids may be injected into the affected joint to reduce inflammation (or taken orally).

Your doctor may insert a needle into the joint to draw out excess fluid. This procedure may help relieve pain and pressure.

One of the primary drugs for treatment is colchicine. It's used to reduce inflammation in the affected joint. But it's associated with serious side effects such as vomiting, diarrhea, hair loss, and bone marrow depression.

Prevention

You can help yourself heal and prevent further episodes from recurring:

• maintain a healthy weight
• exercise regularly
• drink plenty of water
• avoid alcohol
• avoid foods high in purine (e.g., organ meats, red meat, sardines, scallops, sweetbreads, cream sauces)
• eat foods that are fresh, unrefined, and unprocessed
• unsweetened cherries can lower uric acid levels and can prevent attacks
• if you are taking high doses of fish oil supplements, cut back a little to see if symptoms are relieved

Foods containing quercetin (a flavonoid found in fresh fruits and vegetables) have anti-inflammatory and antioxidant properties, and aid in the fight against gout and many other diseases. These include: apples, onions, black/green tea, citrus fruits, red wine, red grapes, raspberries, broccoli, and leafy green vegetables. Some former sufferers swear by vitamin C enriched cherry juice.

healthy foods