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.

Staying healthy, even with gout

Measures You Can Take To Stay Healthy
Maintain a healthy, balanced diet.
Drink plenty of fluids, especially water.
Fluids help remove uric acid from the body.
Avoid foods that are high in purines.

Coffee may cut risk of gout, study finds

If men ever needed a reason to justify that extra cup of coffee, here it is: four or more cups of coffee a day appear to reduce the risk of gout, Canadian researchers said on Friday.
Gout is a painful joint disorder caused by a buildup of uric acid in the blood.

It affects about 6 million people in the United States, and tends to be a bigger problem for men than women.

In the past, patients at risk for gout were advised to avoid coffee, but Dr. Hyon Choi of the University of British Columbia in Vancouver, Canada, and colleagues at Harvard Medical School in Boston wanted to see just what effect coffee might have on the condition.
Choi and colleagues analyzed data from a U.S. health and nutrition survey between 1988 and 1994.

The study is based on a survey of about 50,000 men aged 40 to 75 with no history of gout. They filled out detailed questionnaires about dietary habits, including what they drank.
Over the 12 years of the study, during which 757 men developed gout, the risk was lower for those who drank more coffee, Choi reported in the journal Arthritis & Rheumatism.

"We found that when they are drinking four to five cups of coffee, there was a 40-percent reduction. Drinking six or more cups resulted in a 50- to 60-percent reduction (in the risk for gout)," Choi said in a telephone interview.

Men who drank decaffeinated coffee also benefited, Choi said, but tea appeared to have no effect.

The researchers found significantly lower levels of uric acid in the blood of those who consumed large quantities of coffee. Uric acid is the compound that causes gout

Tips for Gout patients to stay healthy

· To help prevent future attacks, take the gout medications that your doctor prescribes. Carefully follow instructions about how much medicine to take and when to take it. Acute gout is best treated when symptoms first occur.
· Tell your doctor about all the medicines, dietary supplements, and vitamins you take. He or she can tell you if any of them increase your risk of hyperuricemia.
· Plan followup visits with your doctor to evaluate your progress.
· Exercise regularly and maintain a healthy body weight. Lose weight if you are overweight, but do not go on diets designed for quick or extreme loss of weight because they increase uric acid levels in the blood.

Survival Tips

Tips:
1. Maintain adequate fluid intake.
2. Keep your weight under control. Obesity has been linked to gout.
3. Dietary changes can help prevent gout attacks. Avoid a purine-rich diet. Reduce alcohol consumption.
4. Medications can help control pain and inflammation of a gout attack and help prevent future attacks by eliminating excess uric acid or affecting the production of excess uric acid.
5. Be compliant with the treatment plan your doctor recommends.
What You Need:
· Diet low in purines.
· Medication to control pain.
· Medication to control inflammation.
· Medication to control level of uric acid.

Did you know these are used to treat gout?

1. Colchicine is used to treat acute flares of gouty arthritis and to prevent recurrent acute attacks. Colchicine does not cure gout or take the place of other medicines that lower the amount of uric acid in the body. It prevents or relieves gout attacks by reducing inflammation. Colchicine may be used in 2 ways: some people take small amounts of it regularly for months or years, while others take large amounts of colchicine during a short period of time (several hours).
2. Corticosteroids or adrenocorticotropic hormone can be used for patients who cannot take NSAIDS or colchicine. Patients with acute gout typically receive daily doses of prednisone (20-40mg) or its equivalent for 3 to 4 days, then it is tapered gradually over one to two weeks. ACTH is administered as an intramuscular injection (an initial dose and subsequent doses over several days as needed).
3. Allopurinol (brand name - Zyloprim) is prescribed for chronic gout or gouty arthritis and works by affecting the system that manufactures uric acid in the body. It is used to prevent gout attacks, not to treat them once they occur.
4. Probenecid (brand names - Benemid, Probalan) is prescribed for chronic gout and gouty arthritis. It is used to prevent attacks related to gout, not treat them once they occur. It acts on the kidneys to help the body eliminate uric acid. Probenecid is known as a uricosuric agent.
5. ColBenemid (other brand names are Col-Probenecid and Proben-C) is a gout medication that contains Probenecid, which is a uricosuric agent, and Colchicine, which has anti-gout properties.
6. Sulfinpyrazone (brand name - Anturane) is also known as a uricosuric agent and is used to treat gouty arthritis. It works by lowering the amount of uric acid in your blood, preventing gout attacks. The drug helps prevent attacks but is not used to treat an attack once it has started.
7. Losartan, (brand names - Cozaar and Hyzaar), is not specifically a gout medication but is an angiotensin II receptor antagonist, antihypertensive drug that may help control uric acid levels. Fenofibrate, (brand name - Tricor), is not a specific gout medication but it a lipid-lowering drug that may help uric acid levels.

Medications for gout include:

o non-steroidal anti-inflammatory drugs (NSAIDS)
o colchicine
o corticosteroids
o adrenocorticotropic hormone (ACTH)
o allopurinol
o probenecid
o sulfinpyrazone
2. NSAIDS, specifically indomethacin, are commonly the first medication prescribed to treat acute gout. Other NSAIDS may be equally effective. NSAIDS are initially prescribed at maximum dosage and reduced as symptoms subside. The medication should be continued until pain and inflammation are non-existent for at least 48 hours. NSAIDS which are COX-2 inhibitors may be useful for patients with gastrointestinal concerns but their use for acute gout has not been specifically reported yet.

Drinking Four Or More Cups Of Coffee A Day May Help Prevent Gout

Coffee is a habit for more than 50 percent of Americans, who drink, on average, 2 cups per day. This widely consumed beverage is regularly investigated and debated for its impact on health conditions from breast cancer to heart disease. Among its complex effects on the body, coffee or its components have been linked to lower insulin and uric acid levels on a short-term basis or cross-sectionally. These and other mechanisms suggest that coffee consumption may affect the risk of gout, the most prevalent inflammatory arthritis in adult males.

To examine how coffee consumption might aggravate or protect against this common and excruciatingly painful condition, researchers at the Arthritis Research Centre of Canada, University of British Columbia in Canada, Brigham and Women's Hospital, Harvard Medical School, and Harvard School of Public Health in Boston conducted a prospective study on 45,869 men over age 40 with no history of gout at baseline. Over 12 years of follow-up, Hyon K. Choi, MD, DrPH, and his associates evaluated the relationship between the intake of coffee and the incidence of gout in this high risk population.

Their findings provide compelling evidence that drinking 4 or more cups of coffee a day dramatically reduces the risk of gout for men.
Subjects were drawn from an ongoing study of some 50,000 male health professionals, 91 percent white, who were between 40 and 75 years of age in 1986 when the project was initiated. To assess coffee and total caffeine intake, Dr. Choi and his team used a food-frequency questionnaire, updated every 4 years. Participants chose from 9 frequency responses -- ranging from never to 2 to 4 cups per week to 6 or more per day -- to record their average consumption of coffee, decaffeinated coffee, tea, and other caffeine-containing comestibles, such as cola and chocolate.

Through another questionnaire, the researchers documented 757 newly diagnosed cases meeting the American College of Rheumatology criteria for gout during the follow-up period. Then, they determined the relative risk of incident gout for long-term coffee drinkers divided into 4 groups -- less than 1 cup per day, 1 to 3 cups per day, 4 to 5 cups per day, and 6 or more cups per day -- as well as for regular drinkers of decaffeinated coffee, tea, and other caffeinated beverages.

They also evaluated the impact of other risk factors for gout -- body mass index, history of hypertension, alcohol use, and a diet high in red meat and high-fat dairy foods among them -- on the association between coffee consumption and gout among the study participants.
Most significantly, the data revealed that the risk for developing gout decreased with increasing coffee consumption. The risk of gout was 40 percent lower for men who drank 4 to 5 cups a day and 59 percent lower for men who drank 6 or more cups a day than for men who never drank coffee.

There was also a modest inverse association with decaffeinated coffee consumption. These findings were independent of all other risk factors for gout. Tea drinking and total caffeine intake were both shown to have no effect on the incidence of gout among the subjects. On the mechanism of these findings, Dr. Choi speculates that components of coffee other than caffeine may be responsible for the beverage's gout-prevention benefits. Among the possibilities, coffee contains the phenol chlorogenic acid, a strong antioxidant.

While not prescribing 4 or more cups a day, this study can help individuals make an informed choice regarding coffee consumption. "Our findings are most directly generalizable to men age 40 years and older, the most gout-prevalent population, with no history of gout," Dr. Choi notes. "Given the potential influence of female hormones on the risk of gout in women and an increased role of dietary impact on uric acid levels among patients with existing gout, prospective studies of these populations would be valuable."

Quick Gou Facts

Here's How:
1. Typically, gout patients are about 95% men, 5% women. An initial attack of gout (50% of initial attacks involve the big toe) may last several days and disappear even if untreated. Subsequent attacks may not occur for weeks, months, years, or not at all. In severe cases, repeated attacks occurring over a long period may cause damage to the joints and loss of mobility. The big toe is eventually affected in 90% of cases. Knowing how to treat gout is important for preventing attacks.
2. Gout is often related to an inherited abnormality in the body to process uric acid. Uric acid levels can become elevated by eating alot of purine-rich foods such as meats, by the overproduction of uric acid by the body, or if the kidneys do not eliminate excess uric acid.
3. Treatment goals include terminating acute gout attacks, rapid and safe relief of pain and inflammation, preventing future attacks, and avoiding complications (formation of tophi, kidney stones, and joint destruction).
4. Though gout treatment is most often treated successfully and without complications, it becomes more of a challenge if other conditions exist along with gout or if there is poor patient compliance to recommended lifestyle changes or a medication regimen.
5. Dietary alterations are recommended, such as avoiding a purine-rich diet. Other preventive measures include maintaining adequate fluid intake, weight reduction, reduction in alcohol consumption, and medications to reduce hyperuricemia.

Who is affected by gout?

Approximately one million people in the United States suffer from attacks of gout. (Did you know that none other than Benjamin Franklin had terrible gouty arthritis!) Gout is nine times more common in men than in women. It predominantly attacks males after puberty, with a peak age of 75. In women, gout attacks usually occur after menopause.
While an elevated blood level of uric acid (hyperuricemia) may indicate an increased risk of gout, the relationship between hyperuricemia and gout is unclear. Many patients with hyperuricemia do not develop gout, while some patients with repeated gout attacks have normal or low blood uric acid levels. Among the male population in the United States, approximately ten percent have hyperuricemia. However, only a small portion of those with hyperuricemia will actually develop gout.

Gout

Gout generally appears in the form of short attacks, sometimes lasting for several days or weeks. Much like those with kidney stones, gout sufferers can be symptom-free for several years between attacks. Uric acid crystals are also responsible for one form of kidney stones. Gout can become chronic over time, which means the sufferer must take daily medications in order to prevent the onset of major symptoms and extreme pain.
Gout is usually treated through dietary changes and nonsteroidal anti-inflammatory drugs (NSAIDs). During a gout attack, physicians may inject prescription NSAIDs directly into the affected joint, along with a drug designed specifically to reduce the size of uric acid crystals. The use of aspirin for pain relief from gout is strongly discouraged. An over-the-counter NSAID such as Ibuprofen may take the edge off the pain, but will not mask it completely.
At one time in history, gout was viewed as a disease of the wealthy, since the foods which triggered it were primarily available to richer citizens. Research has since shown that the main culprit for the formation of gout is an organic substance called purine. Foods with high levels of purine, including organ meats, beans and red meats, contribute to the body's level of uric acid.

source- wisegeek.com

Gout Symptoms

The first symptom of gouty arthritis is typically the sudden onset of a hot, red, swollen joint. The most common joint involved is at the base of the big toe (podagra), but almost any joint can be involved. In some people, the acute pain is so intense that even a bed sheet on the joint causes pain.

Even without treatment, the first attacks stop spontaneously after 1-2 weeks. While the pain and swelling completely go away, gouty arthritis almost always returns in the same joint or in another joint.

With time, attacks of gouty arthritis occur more frequently and tend to last longer. While the first attacks usually involve only one or two joints, over time multiple joints can be involved simultaneously.

Kidney stones are more frequent in patients with gout.
Uric acid crystals can form outside joints. Collections of these crystals, known as tophi, can be found in the earlobe, elbow, and Achilles tendon (back of the ankle). Typically, these tophi are not painful but can be a valuable clue for the diagnosis.

Diagnosis

The diagnosis is generally made on a clinical basis, although tests are required to confirm the disease.
Hyperuricemia is a common feature; however, urate levels are not always raised.

Hyperuricemia is defined as a plasma urate (uric acid) level greater than 420 μmol/L (7.0 mg/dL) in males (or 380 μmol/L in females); however, high uric acid level does not necessarily mean a person will develop gout. Additionally, urate is within the normal range in up to two-thirds of cases.

If gout is suspected, the serum urate test should be repeated once the attack has subsided. Other blood tests commonly performed are full blood count, electrolytes, renal function and erythrocyte sedimentation rate (ESR). This serves mainly to exclude other causes of arthritis, most notably septic arthritis.

A definitive diagnosis of gout is from light microscopy of joint fluid aspirated from the joint (this test may be difficult to perform) to demonstrate intracellular monosodium urate crystals in synovial fluid polymorphonuclear leukocytes. The urate crystal is identified by strong negative bi-refringence under polarised microscopy, and their needle-like morphology. A trained observer does better in distinguishing them from other crystals.

In much the same way that carbohydrate-rich foods can negatively affect diabetics, foods high in purine can have a serious impact on those with a condition called gout. Gout is essentially a crystallization of excess uric acid not processed by the intestines and kidneys. These crystalline deposits tend to collect in the feet and other major joints, leaving the sufferer in a nearly-constant state of pain unless deposit-busting medications are prescribed. Gout was originally considered a disease of wealth, because only those who could afford a diet rich in purine seemed to contract it.
Today we know that foods high in purine are only one of several contributors to gout. Compromised kidney function or circulatory problems may also be factors. The standard medical advice for gout patients is to begin a diet with no more than 15% protein consumption per day. Not all meats have high levels of purine, but it is still better to restrict protein intake rather than risk temptation from the richer meats and proteins.
Some of the foods rated high in purine include the following: sweetbreads (internal organs), anchovies, sardines, canned liver, kidneys, hearts, meat extracts (broths and bouillon), gravies, and various canned seafoods. Other foods which contain slightly lower levels of purine include wild game and lentils. These are usually the items found on a typical do not eat list for gout patients. Other protein sources such as nuts or ground beef are limited to one serving per day.
As with other restrictive diets, the idea is to reduce the amount of a substance which cannot be naturally rendered harmless. Many healthy people can safely consume larger quantities of purine-rich foods with few problems. Those on high protein diets for weight loss are often encouraged to consume foods high in purine. As long as the body continues to flush away excess uric acid through the kidneys, high protein diets only increase the risk of developing gout, but do not cause the condition directly.
Eating excessive amounts of any foods, whether it be processed carbohydrates or purine, is rarely a good idea from a health perspective, but foods high in purine should be limited to an occasional treat, not a daily part of an average diet. source- wisegeek.com

Foods that cause Gout are...

In general, foods that cause gout are high in fat, which is why dietary recommendations for people with this kind of arthritis advise that less than 30% of their calories come from fat. Proteins with large concentrations of purines include meat and dairy products. Fish, like mackerel, sardines, oysters, mussels, and scallops, should be avoided, as well as red and white meat like poultry, pork, and beef. Sweetmeats, or organ meat, like kidney, heart, or liver, are especially bad for those suffering from gout. Even foods related to meat, like chicken or beef broth, caviar, and bouillon might produce high levels of uric acid.
Other foods that cause gout are dairy and vegetables, because they have lots of purines as well. High-fat dairy, like whole milk, ice cream, butter, and cheese, must be avoided in favor of low-fat dairy, or soy replacements. Spinach, mushrooms, cauliflower, peas, and asparagus have been shown to be rich in purines. In an unrelated food category, lentil beans and yeast increase one's chance of gout flaring up. For this reason, even beer and alcohol, because they are derived from yeast and grains, can increase the discomfort of gout.
Ingesting purines is not the only way to build up an unusually high concentration of uric acid, called hyperuricemia. Poor kidney function, since the kidneys filter out uric acid, works in conjunction with foods that cause gout. Thus, drinking plenty of water and eating tofu, olive oil, and nuts, actually seems to counteract weakened kidneys to eliminate uric acid from the bloodstream. A diet rich in complex carbohydrates, in the form of vegetables, fruits, and whole grains like bread and pasta, may ease the symptoms of gout. A doctor might combine these diet restrictions with anti-inflammatory medication and an overall weight loss plan.

What is Gout?

Gout is a rheumatic disease and its symptoms can be extremely painful. Shard-like deposits of uric acid can build up in connective tissue such as in the joints between bones and cause inflammatory arthritis. The primary noticeable symptoms of gout are lumpy uric acid deposits around the joints and the edge of the ear.
About 75% of gout patients experience pain in the big toe. Joint pains in the foot such as in the ankles, heels and instep are also common symptoms of gout as are joint pains in the knees. Gout can also cause joint pain in the elbows, wrists and fingers. About 5% of all gout cases are arthritis related.
Sometimes, inflammatory symptoms of gout are not actual symptoms of gout, but of a false gout called chondrocalcinosis, or pseudo-gout. Calcium, not uric acid builds up in pseudo-gout. Calcium phosphate crystals are not as serious as uric acid crystal build up is to the body.
Uric acid deposits are serious symptoms of gout as the kidneys can be affected and kidney stones may result. Uric acid occurs in the body when purines are being broken down. Purines are found in many foods including liver, anchovies, dried legumes and gravy and are also part of human tissue. Normally, uric acid is dissolved in the bloodstream and is eliminated from the body in urine. If the uric acid is built up too much and not eliminated, hyperuricemia, or an excess of uric acid, results.
While hyperuricemia is one of the symptoms of gout, it is usually detectable only through medical testing. Hyperuricemia itself is not cause for alarm; it is only harmful when the excess uric acid builds up and forms into crystals in the body. It is the painful, lumpy build up of crystallized uric acid around joints that is one of the major serious symptoms of gout.
Besides the pain caused by the uric acid deposits, some other symptoms of gout are stiffness and redness around the joints. A feeling of heat in the joints is also one of the more common symptoms of gout. Stress can bring on the symptoms of gout as can alcohol, drugs and/or other illnesses. Gout attacks may occur months or years apart, but the attacks and symptoms of gout can become more intense and more frequent over time.
Between the attacks, gout sufferers may experience no symptoms of gout and this is called the "interval stage." Kidney damage is one of the internal symptoms of gout and often occurs in the gout sufferer after ten years or more of living with the disease. Chronic tohpaceous gout is an advanced stage of gout that can be very disabling. Source- wisegeek.com

Drink Water, Eat Tofu

Ingesting purines is not the only way to build up an unusually high concentration of uric acid, called hyperuricemia. Poor kidney function, since the kidneys filter out uric acid, works in conjunction with foods that cause gout. Thus, drinking plenty of water and eating tofu, olive oil, and nuts, actually seems to counteract weakened kidneys to eliminate uric acid from the bloodstream. A diet rich in complex carbohydrates, in the form of vegetables, fruits, and whole grains like bread and pasta, may ease the symptoms of gout. A doctor might combine these diet restrictions with anti-inflammatory medication and an overall weight loss plan.

Other foods that cause gout

Other foods that cause gout are dairy and vegetables, because they have lots of purines as well. High-fat dairy, like whole milk, ice cream, butter, and cheese, must be avoided in favor of low-fat dairy, or soy replacements. Spinach, mushrooms, cauliflower, peas, and asparagus have been shown to be rich in purines. In an unrelated food category, lentil beans and yeast increase one's chance of gout flaring up. For this reason, even beer and alcohol, because they are derived from yeast and grains, can increase the discomfort of gout.

Foods that cause Gout

Gout, a kind of rheumatoid arthritis, gets aggravated when sharp crystal shards of uric acid collect between joints and cause painful inflammation. The body breaks down foods containing purines into uric acid, usually a neutral but unnecessary chemical that is then filtered out of the bloodstream by our kidneys. Certain proteins, as well as beans and vegetables, contain such high levels of purines that these foods can cause gout.
In general, foods that cause gout are high in fat, which is why dietary recommendations for people with this kind of arthritis advise that less than 30% of their calories come from fat. Proteins with large concentrations of purines include meat and dairy products. Fish, like mackerel, sardines, oysters, mussels, and scallops, should be avoided, as well as red and white meat like poultry, pork, and beef. Sweetmeats, or organ meat, like kidney, heart, or liver, are especially bad for those suffering from gout. Even foods related to meat, like chicken or beef broth, caviar, and bouillon might produce high levels of uric acid.

Exercising with gout?

Listen To Your Body
Stop exercising and consult your health care provider if you experience chest discomfort or pain, dizziness, severe headache, or other unusual symptoms while you work out. If pain does not go away, get medical help right away. If you are feeling fatigued or sick, take time off from your routine to rest. You can ease back into your program when you start feeling better.

Awesome Tips for a succesful exercise program

1. Tips to a Safe and Successful Physical Activity Program
o Check with your health care provider. If you have a chronic health problem such as obesity, arthritis, diabetes, heart disease, or high blood pressure, ask your health care provider about what type and amount of physical activity is right for you.
o Start slowly. Incorporate more physical activity into your daily routine and gradually work up to the 30-minute goal to improve health and manage your weight.
2.
o Set goals. Set short-term and long-term goals and celebrate every success.
o Track progress. Keep an activity log to track your progress. Note when you worked out, what activity you did, how long you did the activity, and how you felt during your workout.
o Think variety. Choose a variety of physical activities to help you meet your goals, prevent boredom, and keep your mind and body challenged.
o Be comfortable. Wear comfortable shoes and clothes that are appropriate to the activity.
3.
o Eat nutritious foods. Choose a variety of nutritious foods every day. Remember that your health and weight depend on both your eating plan and physical activity level.
o Get support. Encourage your family and friends to support you and join you in your activity. Form walking groups with coworkers, play with your children outside, or take a dance class with friends.

Who says you can't exercise if you have gout?

Mind and Body Exercises
In addition to aerobic activity and strength training, you may wish to include other forms of exercise in your physical activity program. Alternatives to traditional exercise provide variety and fun. They may also help reduce stress, increase muscular strength and flexibility, and increase energy levels. Examples of these exercises include:
o yoga
o Pilates
o tai chi
2. Keep Moving!
Move at your own pace while you enjoy some of these activities:
o Brisk walking
o Jogging
o Bicycling
o Swimming
o Aerobic exercise classes (step aerobics, kick boxing, high/low)
o Dancing (square dancing, salsa, African dance, swing)
o Playing sports (basketball, soccer)

Getting Strong with Gout

1. Certified Personal Trainers
If you are new to strength training, or physical activity in general, consider hiring a certified personal trainer who can plan an individualized program to help you work out safely and effectively.
A personal trainer who has a degree in exercise physiology or is certified through a national certification program such as the American College of Sports Medicine or National Strength and Conditioning Association may help you to reach your physical activity goals.
2. Get Strong!
To build strong muscles and bones with strengthening exercise. Try:
o Lifting weights
o Using resistance bands
o Using stability or medicine balls
o Doing push-ups and abdominal crunches

Gout is a result of too much uric acid in your blood. Uric acid buildup usually is a sign that your kidneys aren't cleaning our your blood as well they should. Over time, this excess uric acid forms crystals between your joint spaces causing excruciating pain.
There are many foods that promote uric acid buildup and should be avoided. The most common are: alcohol, anchovies, peas, poultry, dark greens vegetables, dried fruits, fish, mushrooms, herring, meat gravies, broth, bouillon, mussels, sardines, red meats, processed meats, fried foods, caffeine, beans, lentils, eggs, oatmeal, and low doses of aspirin.
You are not alone . . . over 2,000,000 Americans have gout and suffer needlessly and globally the statistics are staggering! Left unchecked, it can cause many potential health problems, including heart disease, disability, kidney damage and permanent joint damage!

Adding Physical Activity to Our Daily Lives

1. Getting Started!
To add more physical activity to your daily life try:
o Taking a brisk walk around the block with family, friends, or coworkers.
o Raking the leaves.
o Walking up the stairs instead of taking the elevator when it is safe to do so.
o Mowing the lawn.
o Taking an activity break at work or home. Get up and stretch or walk around.
o Parking your car further away from entrances of stores, movie theatres, or your home and walk the extra distance when it is safe to do so.
2. Strength Training
Strength training is another way for you to meet the recommended minimum of 30 minutes of moderate-intensity physical activity each day. Strength training will also help you burn extra calories and build strong muscles, bones, and joints.
Experts recommend strength training 2 to 3 days each week, with 1 full day of rest between workouts to allow your muscles to recover.

Getting aerobic activity done with gout

Aerobic Activity
You can meet your goal of at least 30 minutes of moderate-intensity physical activity with aerobic activities. Aerobic exercise includes activities that make you breathe harder than when you are resting and increase your heart rate.
Experts recommend moderate-intensity exercise. At this pace, you may breathe harder and find it more difficult to talk, but you should still be able to carry on conversations. If you're just beginning, slowly work up to a moderate-intensity pace.

Physical activity with Arthritis

Regular physical activity can help you reach and maintain a healthy weight.
Being physically active can make you more energetic, improve your mood, and reduce the risk of developing some chronic diseases. Physical activity also helps you feel, move, and look better.
Whether your goal is to achieve and maintain a healthy weight or improve your health, becoming physically active is a step in the right direction.
Learn how to better take advantage of the health benefits of physical activity.
Difficulty: Average
Time Required: Varies
Here's How:
Calories in Food > Calories Used = Weight GainCalories in Food < Calories Used = Weight LossCalories in Food = Calories Used = Weight Control
Physical activity helps you control your weight by using excess calories that would otherwise be stored as fat. Most foods contain calories, and everything you do uses calories, including sleeping, breathing, and digesting food. Balancing the calories you eat with the calories you use through physical activity will help you maintain a healthy weight.
Becoming Physically Active
Experts recommend at least 30 minutes of moderate-intensity physical activity on most, if not all, days of the week. To achieve and maintain a healthy weight, particularly after you have lost a large amount of weight, you may need to do 60 minutes or more of moderate-intensity physical activity each day.
If you have been inactive for a while, start slowly and work up to 30 minutes a day at a pace that is comfortable for you.
Many Forms Of Physical ActivityPhysical activity may include structured activities such as:
cycling
walking
running
swimming
Physical activity also includes daily activities such as household chores, yard work, or walking the dog. Pick a combination of structured and daily activities that fit your schedule.
Note: If you are unable to be active for 30 minutes at one time, accumulate physical activity over the course of the day in 10 to 15 minute sessions.
Health Benefits of Physical Activity
Regular physical activity helps control your weight and may help reduce your risk of or manage chronic diseases such as:
type 2 diabetes
high blood pressure and cholesterol
heart disease
osteoporosis
arthritis
some cancers
Regular physical activity may also help:
Build strong muscles, bones, and joints.
Improve flexibility and balance.
Ward off depression.
Improve mood and sense of well-being.

Green Tea for Arthritis

Green tea, already touted for its cardiovascular and anticancer benefits, may also help ease the inflammation and pain of rheumatoid arthritis, a new study suggests.
The study was conducted in the laboratory, and its findings are preliminary, stressed lead researcher Salah-uddin Ahmed, an investigator at the University of Michigan Health System, in Ann Arbor.
"It's too early" to fully recommend green tea to ease rheumatoid arthritis, he said, but the study "is a starting point."
Ahmed was scheduled to present the research Sunday at the Experimental Biology meeting, in Washington, D.C.
For the study, Ahmed isolated cells called synovial fibroblasts from the joints of patients with rheumatoid arthritis. These cells form a lining of tissue surrounding the capsule of the joints.
In patients with rheumatoid arthritis, this lining is inflamed, leading to long-term joint damage and chronic pain. About 2.1 million Americans have rheumatoid arthritis, according to the Arthritis Foundation.
Ahmed's team next cultured these cells and exposed them to the active ingredient in green tea, a compound named epigallocatechin-3-gallate (EGCG). Next, the cells were stimulated with a protein of the immune system known to play a role in causing joint degradation in rheumatoid arthritis. The protein is called cytokine interleukin-1 beta or IL-1B.
"IL-1B is a major player in mediating cartilage degradation," Ahmed explained.
In an earlier study, Ahmed's team found that fibroblasts pretreated with EGCG and then stimulated with cytokine IL-1B were better able to block IL-1B's ability to produce damaging proteins and enzymes. Those proteins and enzymes can infiltrate the joints and cause the cartilage breakdown seen in people with rheumatoid arthritis.
In the more recent study, the researchers focused on whether EGCG had the ability to block the activity of two potent molecules, IL-6 and cyclooxygenase-2 (Cox-2), which also play a role in breaking down bone in an RA joint.
The two molecules were suppressed by the EGCG, Ahmed's team found. While he said it is difficult to quantify exactly the effect of the suppression, the EGCG "blocked them significantly," he said.
EGCG also blocked the production of prostaglandin E2, another compound that can cause joint inflammation.
One expert said the new green tea study was intriguing. "This study is very specific," said Stephen Hsu, an associate professor of dentistry, molecular medicine and genetics at the medical College of Georgia in Augusta.
In his own research, Hsu has found that green tea may help protect against certain autoimmune diseases, in which the body triggers an immune response, basically attacking its own cells. Hsu studied EGCG's effect in helping to inhibit an autoimmune disorder known as Sjogren's syndrome, in which the salivary glands are affected, and in lupus, in which the skin is affected.
The new research by Ahmed is one of the first to focus on rheumatoid arthritis and green tea, Hsu said. If it bears out, it could be good news for rheumatoid arthritis patients, perhaps offering them a non-drug option to keep pain under control, he said.
Ahmed cautioned that it's too soon to advise rheumatoid arthritis patients to drink green tea. On the other hand, drinking green tea certainly wouldn't hurt, he said, since it is known to have many health benefits and no known side effects.
He said people might want to try drinking three or four 8-ounce cups of green tea per day. "Try different brands," he suggested. The flavors may taste slightly different. "Drink it continuously throughout the day," he said, to keep blood levels more constant.
And you might want to consider popping some tart cherries along with that tea, according to another study presented at the same meeting.
In the study, conducted by another team of University of Michigan researchers, powdered tart cherries appeared to lower total cholesterol and blood sugar and help the body handle fat and sugar -- at least in animals.SOURCES: Salah-uddin Ahmed, Ph.D., research professor, internal medicine-rheumatology, University of Michigan Health System, Ann Arbor, Mich.; Stephen Hsu, Ph.D., associate professor, dentistry, molecular medicine and genetics, Medical College of Georgia, Augusta; Experimental Biology 2007, April 29, 2007, Washington, D.C. Publish Date: May 01, 2007

Treatment options for gout

Rheumatologists will often be involved in the treatment of gout because they specialize in managing this and other forms of arthritis.
A number of medications may be recommended to reduce joint pain and inflammation. To avoid any interactions, patients must advise their physicians if they are taking other drugs.
Medications to treat gout include:
Nonsteroidal anti-inflammatory drugs (NSAIDs). High doses of NSAIDs such as indomethacin or ibuprofen are the most common treatment for acute gouty arthritis. However, aspirin should not be used for this condition because it can elevate levels of uric acid in the blood. Patients who have a history of ulcers or kidney problems, or those taking anticoagulant medication, may be treated with another type of anti-inflammatory medication, or other medications may be used in conjunction with NSAIDs to protect against unwanted side effects.
Corticosteroids. These medications are strong anti-inflammatory hormones, which may be given to patients who cannot use NSAIDs. Corticosteroids may be given in pill form (in high doses) or via injections into the swollen joint. Patients usually begin to improve within a few hours of treatment, and the attack often completely subsides within a week or so. When used long term, however, these medications may produce side effects, such as weight gain, osteoporosis (bone thinning), cataracts, glaucoma and diabetes, and may contribute to hardening of the arteries (atherosclerosis).
Colchicine. This alkaloid drug is often prescribed when NSAIDs or corticosteroids do not control symptoms. However, it is most effective when taken within the first 12 hours of an episode of acute gouty arthritis. Physicians may prescribe it as often as every hour until joint pain and inflammation begin to improve. When taken orally, side effects may include nausea, vomiting, abdominal cramps or diarrhea.
In addition, colchicine may also be prescribed in low doses to prevent further attacks. When taken in low doses, side effects are less likely to occur. Even though the chronic use of colchicine can reduce or prevent attacks of gout, it does not prevent the accumulation of uric acid crystals that can cause joint damage even without attacks of hot, swollen joints.
Colchicine may also be administered intravenously (I.V.), but this form of therapy should be performed only by a physician experienced in it. When done improperly, I.V. colchicine therapy can have severe side effects, including bone marrow toxicity, kidney failure and, in some cases, even death.
Once the acute gouty arthritis is under control, treatment for gout focuses on preventing recurrent attacks and decreasing the levels of uric acid in the blood. Therapy to lower blood levels of uric acid, which may lead to the formation of uric acid crystals in the tissues and joints of the body, may include:
Uricosurics. These medications help the kidneys eliminate excess uric acid in the urine. Uricosurics should be taken with plenty of fluid (at least 68 ounces or 2 liters a day) to prevent the formation of uric acid kidney stones. These drugs are usually prescribed when gout is caused by under-excretion of uric acid, which occurs in most cases. However, uricosurics should not be used by patients with reduced kidney function or those with tophaceous gout.
Allopurinol. This xanthine oxidase inhibitor decreases the production of uric acid by the body and is the most reliable way to lower levels of uric acid in the blood. However, common side effects include stomach pain, headache, diarrhea and rashes.
In very rare cases, some people can develop an extremely severe allergic reaction to allopurinol, which can lead to kidney and liver toxicity as well as become life-threatening. Patients who develop a rash or a fever following use of this agent should seek immediate medical care.
To be effective, medications to reduce uric acid in the blood must be taken regularly and long-term. Stopping the medications often results in recurrence of gout later.
In addition, medications to treat hyperuricemia (high blood levels of uric acid) should not be administered during an episode of acute gouty arthritis because they may intensify and/or prolong the attack. They should be administered only after symptoms (e.g., joint pain and inflammation) subside.
In instances of medication-induced hyperuricemia, switching medications is often the only course of action necessary.
Surgery is rarely needed for gout unless significant joint damage has occurred from lack of effective and timely treatment. Sometimes surgery may be performed to remove large tophi that are draining (oozing), infected or interfere with normal joint movement. In very severe cases, patients may have to undergo joint replacement surgery (arthroplasty).
Treatment for gout should begin early to prevent long–term complications, such as chronic tophaceous gout, the formation of kidney stones and kidney damage. In secondary gout, treatment of the primary condition causing gout may control the disease. source-ivillage.com

Here are the signs

Generally, gout progresses through four stages. During the first stage, a patient has elevated levels of uric acid in the blood (hyperuricemia) but no other signs or symptoms. At this stage, called asymptomatic hyperuricemia, patients seldom require treatment. In addition, not all people with hyperuricemia go on to develop gout.
The second stage of gout is called acute gouty arthritis. It occurs when the patient suddenly experiences a hot, red, swollen joint, caused by the formation of uric acid crystals between the joints. In most cases, the big toe (a condition once known as podagra) or the knee is affected.
The attack often occurs at night and in a single joint, with the pain becoming more severe. When a single joint is involved, the condition is called monoarticular gout. The pain may grow so intense that even a bed sheet on the joint can cause pain. Chills and a mild fever along with a general feeling of malaise may also accompany the severe pain and inflammation.
Monoarticular gout occurs more often in middle-aged patients and usually involves one joint in the lower limbs, especially the big toe (hallux).
Even without treatment, the first episode often disappears spontaneously within three to 10 days, but prompt treatment can abort the attack in a few hours. Although the pain and swelling disappear, gouty arthritis almost always returns in the same joint or in another one.
A patient is usually symptom-free for a period of time. During this third stage, called interval or intercritical gout, a patient does not have any symptoms and has normal function of the joints. The next attack usually occurs within two years, followed by additional attacks thereafter.
If left untreated, the interval between attacks may shorten and they may become increasingly severe and prolonged. Over time, the attacks can begin to involve multiple joints at once – called polyarticular gout – and may be accompanied by a joint infection (e.g., septic arthritis). Polyarticular gout occurs more often in elderly patients and usually involves the joints in the upper extremities, especially the fingers.
In addition, episodes of acute gouty arthritis can be triggered by circumstances that affect blood levels of uric acid, such as certain chronic illness (e.g., diabetes, high blood pressure), injury, surgery, fasting, drinking alcohol, overeating (especially foods rich in purines, such as liver) and taking certain medications (e.g., diuretics, aspirin, immunosuppressives).
People who experience sudden, intense joint pain with fever should see their physician as soon as possible. If gout is left untreated, it can lead to worsening of the pain and permanent joint damage.
When gout goes untreated for several years, it can progress to a condition called chronic tophaceous gout. During this last phase, patients experience chronic pain and inflammation and there is permanent joint damage due to the formation of large masses of uric acid crystals, which also collect in bone and cartilage, such as in the ears. These masses or nodules of crystals are called tophi. They can form near the knuckles and small joints of the fingers and can cause disfigurement. These large masses or lumps may drain and ooze a chalky substance.

About Gout- by ivillage.com

Gout is one of the most painful forms of arthritis. It usually develops when there are chronically high levels of uric acid in the blood. Uric acid is the waste product formed from the breakdown of purines. Purines are substances found in all of the body’s tissues as well as in many foods, such as organ meats (e.g., liver, sweetbreads) and seafood.
The uric acid can form into sharp, needle-like crystals that accumulate in the body’s connective tissues, particularly in the joint space between the bones. These deposits of uric acid crystals (called monosodium urate crystals or MSU) produce swelling, redness, heat, pain and stiffness in the joints. The joints are the most commonly affected part of the body, but crystals can also form beneath the skin (called tophi) and in the kidneys (kidney stones) or other parts of the urinary system.
Uric acid normally dissolves in the blood and passes through the kidneys before being eliminated in the urine. People with gout either produce excessive levels of uric acid or their kidneys have a problem eliminating it. This condition is called hyperuricemia and occurs when uric acid reaches or exceeds 7 milligrams/deciliter in the blood. Not all people with hyperuricemia develop gout, and some patients who do develop gout have normal blood levels of uric acid. The reason for this is not thoroughly understood.
Elevated levels of uric acid also increase the risk of fatal heart disease, according to long-term research using data from the National Health and Nutrition Examination Survey (NHANES).
Gout can be primary or secondary. Primary gout occurs on its own and is due to the body’s overproduction of purines in the liver or an inherent inability to eliminate purines in the urine. Primary gout is uncommon.
Secondary gout, which is much more common, is due to an underlying medical condition or the therapy to treat a medical condition. For instance, diuretics (medications used to treat high blood pressure) help flush water from the body. These medications can retain uric acid, thus causing levels of uric acid to rise.
Gout is sometimes confused with pseudogout because it produces similar symptoms of inflammation and swelling. However, in the latter condition, deposits are made up of calcium phosphate crystals rather than uric acid.
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, gout occurs in about 840 out of every 100,000 people and accounts for about 5 percent of all cases of arthritis. Gout is rare in children and young adults. It is more prevalent in men than women.
Gout is highly treatable. If left untreated, however, it can erode the joints and bones and cause disfigurement. In addition, patients with gout have an increased risk for developing kidney stones because uric acid crystals can also collect in the urinary tract and kidneys, which can impair kidney function.
If gout is properly diagnosed and treated early, most patients experience relief from their symptoms. Patients are advised to seek medical treatment with a rheumatologist because these physicians specialize in the management of gout and other forms of arthritis.

Questions for your doctor regarding gout

Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about gout:
If I have hyperuricemia, does it mean I will get gout?
Am I at risk of developing gout?
Will eating a high-protein diet put me at risk for gout?
Are there specific foods I should avoid?
What test for gout might I undergo, and what do these tests involve?
What are my treatment options for gout?
How long will my treatment last?
Are there any side effects associated with my therapy for gout?
What things should I avoid while undergoing treatment for gout?
Is there any way I can prevent gout?
Do high levels of uric acid increase my risk of heart disease or other conditions in addition to gout?

source-ivillage.com

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Risk factors and causes of gout
Gout, one of the most painful types of arthritis, is often caused by excessive blood levels (above 7 milligrams/deciliter in females and 8 milligrams/deciliter in males) of uric acid (hyperuricemia). But not all people with hyperuricemia will develop gout, and not all people with gout have hyperuricemia. In most cases, the cause of gout is unknown (idiopathic).
Many common conditions are strongly associated with gout, including diabetes, high blood pressure, heart disease, obesity, kidney disease and hyperlipidemia (unhealthy levels of cholesterol and other blood fats). In addition, episodes of acute gouty arthritis can be triggered by a number of factors, including stress, minor trauma, infection, heavy consumption of alcohol and surgery. Recent research suggests that hot, humid weather and dehydration may also trigger attacks.
Physicians have identified the following risk factors for gout:
Family history. Some people are born with an enzyme defect that makes it hard for the body to break down purines. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, about 18 percent of gout patients have a family history of the disease.
Sex and age. Gout occurs more often in men than in women, mostly because women tend to have lower levels of uric acid than men. However, after menopause, women’s levels of uric acid are similar to those of men. In addition, men are more likely to develop gout earlier, usually between the ages of 30 and 50. Women who develop gout generally do so after menopause. This may be especially true if women are prescribed certain medications, such as diuretics for high blood pressure, heart failure, kidney disease or other conditions.
Excessive consumption of alcohol. Drinking too much alcohol, especially beer, can interfere with the body’s ability to eliminate uric acid, as well as introduce more purines (which break down into uric acid) into the diet.
Excessive consumption of foods rich in purines (e.g., organ meats, meats, seafood). Eating too much of these foods may cause high blood levels of uric acid.
Long-term use of certain medications. Many medications have been shown to interfere with the body’s ability to eliminate uric acid, often because they affect kidney function, including diuretics, low-dose aspirin and immunuosuppressives, such as those taken after an organ transplant.In addition, chemotherapy for cancer increases the break down of abnormal cells, releasing large amounts of purines into the body that can cause accumulation of uric acid in the blood.
Anemia. A condition in which the number and volume of red blood cells and the amount of hemoglobin in the blood are lower than normal.
Lymphoproliferative disorders. Conditions in which cells of the lymphatic system grow excessively.
Paget’s disease. A chronic bone disorder that may result in enlarged or deformed bones in one or more regions of the skeleton.
Psoriasis. A common skin inflammation characterized by redness, itching, and thick, dry, silvery scales on the skin.
Exposure to lead. Some studies have linked environmental exposure to lead with gout.

source- ivillage.com

gout

Your flatmate has dermatographism, which is a skin response to physical pressure. The rash that appears is similar to the rash that occurs when you come into contact with nettles. Nettle rash is caused by a chemical contained in the plant. Dermatographism is caused by the pressure of the chopstick on the skin. About 2-5 per cent of the population has dermatographism. It is a form of urticaria, which is a family of conditions that cause skin rashes. People who have urticaria tend to develop raised, itchy red rashes in response to a variety of stimuli. Sometimes the stimulus is chemical, as with nettle rash. But some people will respond in the same way to simple physical pressure on the skin. The redness is caused by the release of the chemical histamine.

Diagnosis of Gout

Diagnosis of gout usually begins with a physical examination and questions about personal and family medical history. A physician may suspect gout if a patient has had a history of acute arthritis, especially in big toe, that has been followed by a period when symptoms have disappeared.
To confirm gout as well as rule out other diseases with similar symptoms (e.g., pseudogout, septic arthritis, rheumatoid arthritis), a physician may perform an arthrocentesis. This procedure uses a needle to withdraw (aspirate) fluid from a joint so the sample can be examined for uric acid crystals. Gout crystals are needle-shaped and are negatively birefringent (unable to split a ray of light in two) under a polarized light microscope, as compared to pseudogout, where crystals are positively birefringent. During an acute attack, the crystals are often present inside white blood cells.
Large deposits of uric acid crystals (tophi) may be removed from beneath the skin in a biopsy to diagnose an advanced stage of gout called chronic tophaceous gout, though this procedure is not commonly performed for diagnosis.
Other tests may include:
Urinalysis. Laboratory analysis of urine samples to measure the amount of uric acid being eliminated by the kidneys. This test is also performed to detect kidney stones.
Blood tests. Laboratory analysis of blood samples to measure uric acid in the blood and detect hyperuricemia, which is present in most cases of gout. Hyperuricemia is defined as more than 7 milligrams of uric acid per deciliter of blood. However, some patients with gout may have normal levels of uric acid, so hyperuricemia is not used to definitively diagnose gout. Blood tests are also used to rule out other arthritic conditions.
X-ray. This imaging test is primarily used to assess joint damage, especially in patients who have had multiple episodes of acute gouty arthritis.
Once a diagnosis has been made, treatment should be started immediately to avoid long-term complications of untreated gout, such as chronic tophaceous gout, kidney stones and kidney damage. Sometimes it becomes difficult to diagnose gout clinically, especially if it affects an atypical joint in the beginning and the person has normal values of uric acid.

source-http://pain.health.ivillage.com/arthritis/gout5.cfm

Gout Prevention Methods- what to do and what to avoid

In general, keeping uric acid within a normal range (under 7 milligrams/deciliter) is the long-term key to preventing buildup of uric acid, which may lead to gout and/or bouts of acute gouty arthritis (episodes of severe joint pain and swelling) in people diagnosed with the disease. This can be achieved by:
Maintaining a healthy body weight. Patients can achieve and maintain a healthy body weight by eating a balanced diet and exercising regularly.
Avoiding excessive consumption of foods rich in purines. It should be noted that all meat, fish and poultry contain moderate amounts of purines. However, some are more rich in these substances than others, such as:
Seafood (e.g., anchovies, sardines, fish roes, haddock, salmon, smelt, herring, mackerel, trout, mussels, scallops)
Organ meats (e.g., liver, hearts, kidneys, sweetbreads)
Bacon
Poultry (e.g., grouse, turkey, partridge, goose, pheasant)
Other meats (e.g., mutton, veal)
Yeast
Legumes and vegetables (e.g., beans, peas, mushrooms, cauliflower, spinach)
Limiting or avoiding alcohol. Drinking excessive amounts of alcohol, especially beer, can inhibit the elimination of uric acid and cause dehydration, which in turn may lead to gout. Also, if a patient is experiencing a gout attack, it is best to abstain from alcohol to prevent worsening of symptoms.
Drinking plenty of fluids (at least 68 ounces or 2 liters a day). Fluids help dilute uric acid in the blood and urine. It is especially important for gout patients to avoid dehydration during hot and humid weather.
Avoiding use of the inflamed joint during an acute attack until pain and inflammation disappear.
Limited research has suggested that eating cherries might help prevent or relieve gout. Additional studies would be needed to establish this connection. The U.S. Food and Drug Administration (FDA) has warned companies not to market juice and other cherry products as a treatment or preventive measure for gout, other forms of arthritis or other diseases.
When gout is properly treated, the prognosis is excellent, and many patients experience relief from their symptoms and live productive lives.

Gout Prevention Methods- what to do and what to avoid

In general, keeping uric acid within a normal range (under 7 milligrams/deciliter) is the long-term key to preventing buildup of uric acid, which may lead to gout and/or bouts of acute gouty arthritis (episodes of severe joint pain and swelling) in people diagnosed with the disease. This can be achieved by:
Maintaining a healthy body weight. Patients can achieve and maintain a healthy body weight by eating a balanced diet and exercising regularly.
Avoiding excessive consumption of foods rich in purines. It should be noted that all meat, fish and poultry contain moderate amounts of purines. However, some are more rich in these substances than others, such as:
Seafood (e.g., anchovies, sardines, fish roes, haddock, salmon, smelt, herring, mackerel, trout, mussels, scallops)
Organ meats (e.g., liver, hearts, kidneys, sweetbreads)
Bacon
Poultry (e.g., grouse, turkey, partridge, goose, pheasant)
Other meats (e.g., mutton, veal)
Yeast
Legumes and vegetables (e.g., beans, peas, mushrooms, cauliflower, spinach)
Limiting or avoiding alcohol. Drinking excessive amounts of alcohol, especially beer, can inhibit the elimination of uric acid and cause dehydration, which in turn may lead to gout. Also, if a patient is experiencing a gout attack, it is best to abstain from alcohol to prevent worsening of symptoms.
Drinking plenty of fluids (at least 68 ounces or 2 liters a day). Fluids help dilute uric acid in the blood and urine. It is especially important for gout patients to avoid dehydration during hot and humid weather.
Avoiding use of the inflamed joint during an acute attack until pain and inflammation disappear.
Limited research has suggested that eating cherries might help prevent or relieve gout. Additional studies would be needed to establish this connection. The U.S. Food and Drug Administration (FDA) has warned companies not to market juice and other cherry products as a treatment or preventive measure for gout, other forms of arthritis or other diseases.
When gout is properly treated, the prognosis is excellent, and many patients experience relief from their symptoms and live productive lives.

Summary of Gout- all you need to know

Gout is a very painful form of arthritis that can develop when blood levels of uric acid are chronically 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.
Gout can occur on its own, but it is more often associated with other medical conditions or medications prescribed to treat other conditions, such as diuretics (used to treat high blood pressure), that may interfere with the body's ability to remove uric acid.
This buildup of uric acid (hyperuricemia) 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.
Joints are most often affected, but uric acid crystals can also accumulate under the skin and in the kidneys and urinary tract. 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 large joint of the big toe is usually affected first.
Symptoms may initially disappear within three to 10 days, but if left untreated, gout can lead to increasing pain and joint damage. In some cases, the function of the kidneys and the urinary tract can be affected. People with gout are also more likely to develop kidney stones and other complications.
However, not everyone with high levels of uric acid will develop gout. Although it is not known why some people develop gout and not others, risk factors include family history of gout, excessive consumption of alcohol, diet, frequent use of some medications, and medical conditions including obesity, heart disease, kidney disease and diabetes. In addition, men are much more likely than women to develop gout. Some people may develop gout even with normal levels of uric acid in the blood.
Treatment focuses on reducing joint inflammation, preventing further episodes of acute gouty arthritis and decreasing the high blood levels of uric acid with medication and lifestyle changes (e.g., maintaining a healthy weight, avoiding alcohol and foods high in purines such as organ meats and sardines).
Gout is highly treatable. Most patients who receive prompt treatment and follow guidelines can relieve attacks and sometimes avoid an impending attack. But repetitive attacks can permanently damage joints.

Forms of arthritis

Arthritis is any pain that occurs in a joint. The two main forms of arthritis are osteoarthritis and rheumatoid arthritis. Others include juvenile arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Reiter's syndrome, gout and pseudogout.
Treatment focuses on alleviating pain, preventing further degeneration and maintaining or improving joint mobility. Medications are used include acetaminophen, NSAIDs and DMARDs. Glucosamine & chondroitin supplements may also help relieve the chronic pain of arthritis. In some cases, surgical procedures such as arthroscopy and arthroplasty may be necessary.

Have gout? This is what you need to know

Tips:
1. Maintain adequate fluid intake.
2. Keep your weight under control. Obesity has been linked to gout.
3. Dietary changes can help prevent gout attacks. Avoid a purine-rich diet. Reduce alcohol consumption.
4. Medications can help control pain and inflammation of a gout attack and help prevent future attacks by eliminating excess uric acid or affecting the production of excess uric acid.
5. Be compliant with the treatment plan your doctor recommends.

What You Need:
· Diet low in purines.
· Medication to control pain.
· Medication to control inflammation.
· Medication to control level of uric acid.

Gout treatment description

1. Probenecid (brand names - Benemid, Probalan) is prescribed for chronic gout and gouty arthritis. It is used to prevent attacks related to gout, not treat them once they occur. It acts on the kidneys to help the body eliminate uric acid. Probenecid is known as a uricosuric agent.
2. ColBenemid (other brand names are Col-Probenecid and Proben-C) is a gout medication that contains Probenecid, which is a uricosuric agent, and Colchicine, which has anti-gout properties.
3. Sulfinpyrazone (brand name - Anturane) is also known as a uricosuric agent and is used to treat gouty arthritis. It works by lowering the amount of uric acid in your blood, preventing gout attacks. The drug helps prevent attacks but is not used to treat an attack once it has started.
4. Losartan, (brand names - Cozaar and Hyzaar), is not specifically a gout medication but is an angiotensin II receptor antagonist, antihypertensive drug that may help control uric acid levels. Fenofibrate, (brand name - Tricor), is not a specific gout medication but it a lipid-lowering drug that may help uric acid levels.
5. 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.

Things that treat Gout

1. NSAIDS, specifically indomethacin, are commonly the first medication prescribed to treat acute gout. Other NSAIDS may be equally effective. NSAIDS are initially prescribed at maximum dosage and reduced as symptoms subside. The medication should be continued until pain and inflammation are non-existent for at least 48 hours. NSAIDS which are COX-2 inhibitors may be useful for patients with gastrointestinal concerns but their use for acute gout has not been specifically reported yet.
2. Colchicine is used to treat acute flares of gouty arthritis and to prevent recurrent acute attacks. Colchicine does not cure gout or take the place of other medicines that lower the amount of uric acid in the body. It prevents or relieves gout attacks by reducing inflammation. Colchicine may be used in 2 ways: some people take small amounts of it regularly for months or years, while others take large amounts of colchicine during a short period of time (several hours).
3. Corticosteroids or adrenocorticotropic hormone can be used for patients who cannot take NSAIDS or colchicine. Patients with acute gout typically receive daily doses of prednisone (20-40mg) or its equivalent for 3 to 4 days, then it is tapered gradually over one to two weeks. ACTH is administered as an intramuscular injection (an initial dose and subsequent doses over several days as needed).
4. Allopurinol (brand name - Zyloprim) is prescribed for chronic gout or gouty arthritis and works by affecting the system that manufactures uric acid in the body. It is used to prevent gout attacks, not to treat them once they occur.

Heal Gout

Dietary alterations are recommended, such as avoiding a purine-rich diet. Other preventive measures include maintaining adequate fluid intake, weight reduction, reduction in alcohol consumption, and medications to reduce hyperuricemia.


Medications for gout include:
o non-steroidal anti-inflammatory drugs (NSAIDS)
o colchicine
o corticosteroids
o adrenocorticotropic hormone (ACTH)
o allopurinol
o probenecid
o sulfinpyrazone

Fast Facts

Typically, gout patients are about 95% men, 5% women. An initial attack of gout (50% of initial attacks involve the big toe) may last several days and disappear even if untreated. Subsequent attacks may not occur for weeks, months, years, or not at all. In severe cases, repeated attacks occurring over a long period may cause damage to the joints and loss of mobility. The big toe is eventually affected in 90% of cases. Knowing how to treat gout is important for preventing attacks.
Gout is often related to an inherited abnormality in the body to process uric acid. Uric acid levels can become elevated by eating alot of purine-rich foods such as meats, by the overproduction of uric acid by the body, or if the kidneys do not eliminate excess uric acid.
Treatment goals include terminating acute gout attacks, rapid and safe relief of pain and inflammation, preventing future attacks, and avoiding complications (formation of tophi, kidney stones, and joint destruction).
Though gout treatment is most often treated successfully and without complications, it becomes more of a challenge if other conditions exist along with gout or if there is poor patient compliance to recommended lifestyle changes or a medication regimen. - Carol & Richard Eustice

Pseudogout Prevention

There is no known way to prevent this disorder. However, treatment of a lnown predisposing condition may reduce the severity of pseudogout and may in effect prevent it from developing in unaffected patients.

Treatment of Pseudogout

Treatment may involve joint aspiration to relieve pressure within the joint caused by fluid buildup. A needle is placed into the joint and fluid is removed (aspirated).
Steroid injections may be helpful to treat severely inflamed joints. A course of oral steroids is sometimes used when multiple joints are inflamed.
Nonsteroidal anti-inflammatory medications (NSAIDS) may help ease the pain of acute attacks. Colchicine may be useful in some people.

Overview

Definition:
Pseudogout is a joint disease that may include intermittent attacks of arthritis.

Alternative Names:
Calcium pyrophosphate deposition disease; CPPD

Signs and tests:
Culture of joint fluid reveals white blood cells and calcium pyrophosphate crystals.
Joint X-rays may show joint damage, calcification of cartilage, and chondrocalcinosis (calcium deposits in joint spaces).

Pseudogout Information

Causes, incidence, and risk factors:
Pseudogout is caused by the collection of calcium pyrophosphate crystals in joints. There may be attacks of joint swelling and pain in the knees, wrists, ankles, and other joints.
This condition primarily affects the elderly and usually has no known cause. However, it can sometimes affect younger patients who have conditions such as acromegaly, ochronosis, thyroid disease, hemochromatosis, Wilson disease, and parathyroid disease, which are known to increase risk.
Pseudogout can be initially be misdiagnosed as gouty arthritis, rheumatoid arthritis, or osteoarthritis because the symptoms are similar to those of these conditions.
Careful workup, with analysis of crystals found in joints, should ultimately lead to the correct diagnosis. Fortunately, because most conditions involving joint pain are treated by the same medicines, early misdiagnosis does not necessarily result in inappropriate treatment. Such treatment often includes steroids and nonsteroidal anti-inflammatory drugs (NSAIDs).

What Can People With Gout Do To Stay Healthy?

To help prevent future attacks, take the gout medications that your doctor prescribes. Carefully follow instructions about how much medicine to take and when to take it. Acute gout is best treated when symptoms first occur.
Tell your doctor about all the medicines, dietary supplements, and vitamins you take. He or she can tell you if any of them increase your risk of hyperuricemia.
Plan followup visits with your doctor to evaluate your progress.
Exercise regularly and maintain a healthy body weight. Lose weight if you are overweight, but do not go on diets designed for quick or extreme loss of weight because they increase uric acid levels in the blood.

Gout's surprising prevalence

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.

TREATMENT

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.

A painful form of arthritis

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

Gout overview

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.

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.

Points of Interest About Gout:

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.

Overview of Gout symptoms

Acute pain in the toe, swelling
The most common Gout symptom is acute pain in the big toe, which becomes tender, hot, and swollen in a few hours. It may also similarly affect other joints such as the knees and wrists, and sometimes more than one joint may be affected at a time. The attack, usually occurs at midnight or in the early hours of the morning when the patient is suddenly awakened. The acute attack generally lasts for a week or so. During this period, the patient may run a slight fever, and feel disinclined to eat. A serious complication of gout is the presence of kidney stones containing uric acid. In some cases the kidneys get damaged and do not function properly.

low fat dairy products- a BIG help

A study published in the New England Journal of Medicine on Mar 11, 2004 revealed that high intake of low-fat dairy products indeed reduces the risk of gout by 50%. It is unknown why low-fat dairy products offer a protective effect. Unfortunately, no natural supplements are proven effective to prevent or alleviate onset of acute gout attacks. The most effective treatment for gout attack is medication.

Tips on gout diet

Avoid High-Purine foods
Sweetbreads
Anchovies
Sardines
Liver
Beef kidneys
Brains
Meat extracts (e.g Oxo, Bovril)
Herring
Mackerel
Scallops
Game meats
Gravy

Use in Moderation
Vegetables: asparagus, cauliflower, spinach, mushrooms and green peas
Lentils, dried peas and beans
Beef, pork, poultry, fish and seafood
Oatmeal, wheat bran and wheat germ

Home Remedies

Read on for home remedy for Gout:

Apples are considered valuable in the treatment of gout. Consume an apple after every meal.
Extract the juice of half lemon and pour it in 1 glass of water. Drink it three times in a day.
The juice of French beans has proved beneficial in treating gout. Drink half cup of this juice everyday for about a month.
Bananas serve as an excellent remedy for curing gout. Consume a diet of bananas for three to four days.

To MissyJ

Hi Missy! You asked me if I had any information on apples and Gout. Well I found this information that I think you might find interesting. Let me know what you think, OK?

'Apples are regarded as an excellent source for curing gout. The malic acid contained in them is believed to neutralise the uric acid and afford relief to gout sufferers. The patient is advised to take one apple after each meal. '

'Apples are regarded an excellent food medicine for gout, arthritis and rheumatism especially when these diseases are caused by uric acid poisoning. The malic acid contained in them is believed to neutralise the uric acid and afford relief to the sufferers. Apples, boiled to a jelly, make a very good liniment for rheumatic pains. They should be rubbed freely on the affected area. '

what you need

Hi everyone! Here is some great advic o what you need if you hae gout. Keep this in mind:

What You Need:
Diet low in purines.
Medication to control pain.
Medication to control inflammation.
Medication to control level of uric acid.

Tips for Gout patients

Tips:
Maintain adequate fluid intake.
Keep your weight under control. Obesity has been linked to gout.
Dietary changes can help prevent gout attacks. Avoid a purine-rich diet. Reduce alcohol consumption.
Medications can help control pain and inflammation of a gout attack and help prevent future attacks by eliminating excess uric acid or affecting the production of excess uric acid.
Be compliant with the treatment plan your doctor recommends.

Different Gout Treatments

Corticosteroids or adrenocorticotropic hormone can be used for patients who cannot take NSAIDS or colchicine. Patients with acute gout typically receive daily doses of prednisone (20-40mg) or its equivalent for 3 to 4 days, then it is tapered gradually over one to two weeks. ACTH is administered as an intramuscular injection (an initial dose and subsequent doses over several days as needed).
Allopurinol (brand name - Zyloprim) is prescribed for chronic gout or gouty arthritis and works by affecting the system that manufactures uric acid in the body. It is used to prevent gout attacks, not to treat them once they occur.
Probenecid (brand names - Benemid, Probalan) is prescribed for chronic gout and gouty arthritis. It is used to prevent attacks related to gout, not treat them once they occur. It acts on the kidneys to help the body eliminate uric acid. Probenecid is known as a uricosuric agent.
ColBenemid (other brand names are Col-Probenecid and Proben-C) is a gout medication that contains Probenecid, which is a uricosuric agent, and Colchicine, which has anti-gout properties.
Sulfinpyrazone (brand name - Anturane) is also known as a uricosuric agent and is used to treat gouty arthritis. It works by lowering the amount of uric acid in your blood, preventing gout attacks. The drug helps prevent attacks but is not used to treat an attack once it has started.
Losartan, (brand names - Cozaar and Hyzaar), is not specifically a gout medication but is an angiotensin II receptor antagonist, antihypertensive drug that may help control uric acid levels. Fenofibrate, (brand name - Tricor), is not a specific gout medication but it a lipid-lowering drug that may help uric acid levels.
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.