Gout Screening Quiz

Gout is one of the most painful types of arthritis. Do you have symptoms which are associated with gout? Do you have a lifestyle which increases the risk factors associated with gout? Take our Gout Screening Quiz. -health.about.com

Points of Interest About Gout:

Gout was once referred to as "the disease of kings" because it was thought to be rooted in overindulgence in the food and drink that only the rich could afford.
Gout is strongly associated with obesity, hypertension, diabetes, and hyperlipidemia.
Gout seems to run in families, indicating a genetic aspect.

Risk factors for gout include: obesity or weight gain, heavy alcohol ingestion, high blood pressure, abnormal kidney function, and hypothyroidism.
Other events which can precipitate a gout attack include taking certain medications, dehydration, fever, joint injury, and recent surgery.

2.1 million Americans

Gout is actually a disease with a long history. Benjamin Franklin reportedly suffered terribly from gouty arthritis. According to the Arthritis Foundation, approximately 2.1 million Americans are affected by gout. Though it can affect anyone at any age, gout typically affects men between 40 and 50 years old. Gout is nine times more common in men than women. As for women who have gout, the painful condition usually develops after menopause.

Diagnosis and Treatment- Important Information!

Diagnosis of Gout:
Proper diagnosis is important. Diagnosis is based on physical findings and diagnostic tests including the identification of characteristic crystals. Fluid is extracted from the affected joint and a microscopic examination revealing monosodium urate crystals would be consistent with the diagnosis of gout. Crystals known as tophi may also be found in deposits under the skin. Blood uric acid levels are less useful or definitive. The blood uric acid level can be normal or low during an attack or can be elevated in people who have never had a gout attack.
Treatment of Gout:
Treatment of gout involves medications and lifestyle modifications. Medications include:
NSAIDs (nonsteroidal anti-inflammatory drugs) - used to decrease pain and inflammation
Corticosteroids - for people who cannot take NSAIDs
Probenecid and sulfinpyrazone - help kidneys eliminate uric acid (sulfinpyrazone is not currently available in the U.S.)
Allopurinol - blocks production of uric acid
Colchicine - for acute gout attacks or as a prophylactic
Lifestyle modifications are important; they include weight management, abstaining from alcohol, and avoiding meats, seafood and other foods high in purines.

Gout Basics

Gout is considered one of the most intensely painful types of arthritis. Gout is characterized by sudden onset of severe pain, tenderness, warmth, redness, and swelling from inflammation of the affected joint. Gout usually affects a single joint and most often the big toe is affected (i.e. podagra). The knee, ankle, foot, hand, wrist, and elbow may also be affected. Shoulders, hips, and spine may eventually be affected by gout, but rarely. Other conditions which mimic gout include:
• pseudogout
• psoriatic arthritis
• rheumatoid arthritis
• infection
Causes of Gout:
Gout develops from an accumulation of excess uric acid in the body which causes uric acid crystals to deposit in the joints. Excess uric acid can result from increased uric acid production or decreased elimination of uric acid from the body. Certain purine-rich foods can cause an increase in uric acid levels. Some medications also can cause increased uric acid levels.
Symptoms Associated With Gout:
During an acute episode of gout, the patient may be startled by the suddenness and severity of joint pain and swelling. Often the first gout attack occurs at night. Observation of the foot may reveal red or purple shiny skin around the joint. Typically the gout attack goes away after 5-10 days. Without treatment, gout attacks may occur with more frequency and may last longer. Frequent gout attacks can damage the affected joint.

10 Things You Should Know About Colchicine

Colchicine is the preferred treatment for acute gouty arthritis. Though the drug is significant for gout treatment, there is a lot which is not commonly known about colchicine. For example, how colchicine works, from where it is derived, how long has it had a medicinal purpose, and most importantly, what you need to know to use the drug safely. Here are 10 important facts about colchicine.
1 - Colchicine is an alkaloid derived from the dried seeds of Colchicum autumnale, also known as the autumn crocus or meadow saffron.
The use of the Colchicum alkaloid for the treatment of acute gout dates back to 1810. The medicinal value of colchicum was reported back in the first century A.D.

Colchicine was approved by the FDA in 1939. The drug has been used to manage conditions other than gout, including:
amyloidosis
Behcet's disease
dermatitis herpetiformis
familial Mediterranean fever
Paget's disease
pericarditis
pseudogout
biliary and hepatic cirrhosis
2 - Colchicine is available in oral or intravenous dosages.
Colchicine is available in two oral strengths - 0.5 mg and 0.6 mg tablets. The drug is also available intravenously but there is potential for serious toxicity using the parenteral route (i.e., intravenous or injection, a route other than the digestive tract).
3 - Colchicine has anti-inflammatory properties but its use for types of pain other than gout is limited.
Although colchicine is considered highly effective for treating acute gouty arthritis, it is not effective for all types of pain. Colchicine is not considered an analgesic (painkilling) drug. It also does not affect uric acid clearance.
4 - Colchicine works differently than other pain relievers or anti-inflammatory drugs.
Colchicine binds to proteins in the microtubules of neutrophils. Neutrophils are a type of white blood cell. By binding them, the neutrophils cannot migrate to the area of inflammatory response to uric acid crystal deposits. Colchicine has a suppressive effect that helps to decrease acute gout attacks, thereby relieving pain and discomfort associated with gout.
5 - Colchicine is also recommended for regular use between attacks as a prophylactic measure, and may be effective in stopping an attack when taken at the first sign of discomfort.
The usual dose to relieve a gout attack is 1 to 1.2 mg (two 0.5 mg or two 0.6 mg tablets). This dose may be followed by one unit of either strength tablet every hour, or two units every two hours, until pain is relieved or until diarrhea ensues. After the initial dose, it is sometimes sufficient to take 0.5 or 0.6 mg every two or three hours. The drug should be stopped if there is gastrointestinal discomfort or diarrhea.
6 - Colchicine may be administered continuously as a preventive treatment.
In patients who have less than one gout attack per year, the usual dose is 0.5 or 0.6 mg per day, three or four days a week. For those who have more than one attack per year, the usual dose is 0.5 or 0.6 mg daily. Severe cases may require two or three 0.5 mg or 0.6 mg tablets daily.
7 - Adverse reactions can occur with colchicine use and it's important that you are aware of the potential.
Bone marrow depression, with aplastic anemia, with agranulocytosis or with thrombocytopenia may occur in patients receiving long-term therapy.
Other possible adverse reactions include:
peripheral neuritis
purpura
myopathy
hair loss
reversible azoospermia (complete absence of sperm)
Vomiting, diarrhea, and nausea are side effects which may occur with colchicine therapy, especially when maximal doses are necessary.
8 - There are no adequate and well-controlled studies of colchicine use in pregnant women.
Colchicine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Colchicine can arrest cell division so it may be a significant risk to use it while pregnant. Caution should also be exercised when colchicine is administered to a woman who is nursing.
9 - Colchicine should not be used by certain patients.
Colchicine should not be used by a person with a known hypersensitivity to the drug, or by a patient with serious gastrointestinal, renal, hepatic, or cardiac disorders. Also, patients with blood disorders should not use colchicine.
10 - Colchicine requires a prescription written by your doctor.
Colchicine is a prescription medication and is only available in generic form. It is recommended that to decrease side effects, colchicine should be taken with food.

From Carol & Richard Eustice

Purines and Analgesic Painkillers

Along with specific prescribed medications, it is typically recommended that people with gout reduce their intake of purine-rich foods. Consider though that purines are found in all protein foods and it is not recommended that all purines should be eliminated from a person's diet.

Analgesic painkillers are also used to relieve the intense pain of gout. All of the aforementioned drugs can be used in combination, to control symptoms, prevent future attacks, and maintain healthy uric acid levels.