What is Gout?
[Linda Johnson, GlobalRPh Medical Writer] Gout, a form of arthritis, is a disease that has plagued man for hundreds of years and continues to do so today. It is caused by too much uric acid in the blood. Uric acid is a natural waste product that occurs when your body breaks down certain types of foods such as organ meats, which contain a class of chemicals called purines. Due to a deficiency of the digestive enzyme uricase, people who have gout are unable to break down and excrete uric acid, allowing levels of it to build up in the blood, a condition called hyperuricemia. Thus, uric acid crystals accumulate in the body’s connective tissue in and around joints, causing pain and swelling. Uric acid crystals can also collect in the kidneys and lead to kidney stones and eventually kidney failure. |
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Who Suffers from Gout? |
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Approximately two million people suffer with gout, with between 75-90% being middle-aged men. Women usually get gout only after menopause, possibly due to the drop in estrogen women experience after menopause. | ||||||||||||||||||||||||||||||||||
What Causes Gout? |
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There are numerous risk factors that are associated with gout, such as:
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What are the Stages of Gout? |
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An attack of gout usually comes on suddenly and can last for days. Surprisingly a frequent area of a gout attack is in the big toe, commonly known as podagra or “gouty big toe.” Approximately 75% of first attacks are in the big toe. Other joints, such as the ankle, heel, instep, knee, wrist, elbow, fingers, and spine can also be affected.
There are four stages that the disease gout can pass through:
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What Medications are Used to Treat Gout? |
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If untreated, gout can lead to high blood pressure, deformed joints, and even death from kidney failure. Fortunately gout can be easily controlled with medicine. Typically gout is treated with one or a combination of drug therapies. The main goals of treatment are to ease pain, prevent future attacks, and to avoid the formation of kidney stones.
Acute gout attacks are commonly treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, which reduce the inflammation caused by the uric acid crystals, and thus reduces pain. Another type of anti-inflammatory drug which may be prescribed is colchicine. This drug is most effective when taken within the first twelve hours of an attack. Allopurinol reduces the amount of uric acid which is produced in the body. Drugs such as allopurinol, probenecid, or sulifinpyrazone may be prescribed to treat hyperuricemia and to reduce the frequency of sudden attacks.
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Can a Proper Diet Help? |
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In addition to taking the proper medicines, following a special diet is important to try to keep gout symptoms under control.
If you experience gout symptoms it is best to limit your intake of foods high in purine (see table below). Alcohol, especially beer, should be avoided. In fact, limiting total alcohol consumption to 1-3 drinks per week is advised. However, do drink plenty of water as adequate fluid intake helps to dilute urinary uric acid. Consume a moderate amount of protein, limiting meat, fish and poultry to 4-6 oz. per day. The best types of protein to consume are low purine proteins such as low fat dairy products, tofu, and eggs. As obesity can result in increased uric acid production by the body, maintaining a healthy body weight is also important for gout sufferers. If you are over-weight do not follow a high-protein & low-carb diet as this type of diet can worsen gout conditions.
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Conclusion |
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Gout is a serious and painful disease which can potentially be debilitating and life threatening if untreated. Fortunately today, using modern medicine and diet, most people who suffer from gout do not develop to the fourth and most disabling stage of the disease. Almost all of the approximately two million people who are afflicted with gout are able to control their symptoms and live productive lives. |