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What is gout?

Gout is a complex form of arthritis characterized by sudden, severe attacks of pain, redness and tenderness in joints, often the joint at the base of the big toe.

Gout can affect anyone. Men are more likely to get gout, but women become increasingly susceptible to gout after menopause.

An acute attack of gout can wake you up in the middle of the night feeling like your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it seems intolerable.

Fortunately, gout is treatable, and there are ways to reduce the risk that gout will recur.

What causes gout?

Gout occurs when urate crystals accumulate around your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines — substances that are found naturally in your body — as well as in certain foods, such as organ meats, anchovies, herring, asparagus and mushrooms. Most of the time, having too much uric acid is not harmful. Many people with high levels in their blood never get gout. Your chances of getting gout are higher if you are overweight, a family meber has gout, drink too much alcohol, or eat too much meat and fish that are high in chemicals called purines. Some medicines, such as water pills (diuretics), can also bring on gout. What are the symptoms? The most common sign of gout is a nighttime attack of swelling, tenderness, redness, and sharp pain in your big toe. The big toe joint is most commonly affected. But the joints of the feet, ankles, knees, wrists, fingers, and elbows may also be involved. Inflammation of the fluid sacs (bursae) that cushion tissues may occur, particularly in the elbow (olecranon bursitis) and knee (prepatellar bursitis). The attacks can last a few days or many weeks before the pain goes away. Another attack may not happen for months or years. Gout may first appear as nodules (tophi) on the hands, elbows, or ears. There may be no classic symptoms of a gout attack.

See your doctor even if your pain from gout is gone. The buildup of uric acid that led to your gout attack can still harm your joints.

How is gout diagnosed?

Your doctor will ask questions about your symptoms and do a physical exam. Your doctor may also take a sample of fluid from your joint to look for uric acid crystals.

This is the best way to test for gout. Your doctor may also do a blood test to measure the amount of uric acid in your blood.

How is it treated?

To stop a gout attack, your doctor can give you a shot of corticosteroids, or prescribe a large daily dose of one or more medicines. The doses will get smaller as your symptoms go away. Relief from a gout attack often begins within 24 hours if you start treatment right away.

To ease the pain during a gout attack, rest the joint that hurts. Taking ibuprofen or another anti-inflammatory medicine can also help you feel better. But don't take aspirin. It can make gout worse by raising the uric acid level in the blood.

To prevent future attacks, your doctor can prescribe a medicine to reduce uric acid buildup in your blood. If your doctor prescribes medicine to lower your uric acid levels, be sure to take it as directed. Most people continue to take this medicine for the rest of their lives.

Paying attention to what you eat may help you manage your gout. Eat moderate amounts of a healthy mix of foods to control your weight and get the nutrients you need. Avoid regular daily intake of meat, seafood, and alcohol (especially beer). Drink plenty of water and other fluids.

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