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!
Wednesday, May 30, 2007
Tuesday, May 29, 2007
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.
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.
Monday, May 28, 2007
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.
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.
Sunday, May 27, 2007
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.
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.
Friday, May 25, 2007
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
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
Wednesday, May 23, 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
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
Tuesday, May 22, 2007
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.
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.
Monday, May 21, 2007
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.
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.
Friday, May 18, 2007
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?
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
Thursday, May 17, 2007
Do you already know this?
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.
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
Wednesday, May 16, 2007
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.
Tuesday, May 15, 2007
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.
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.
Monday, May 14, 2007
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.
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.
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.
Friday, May 11, 2007
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.
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.
Thursday, May 10, 2007
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.
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.
Wednesday, May 9, 2007
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.
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.
· Diet low in purines.
· Medication to control pain.
· Medication to control inflammation.
· Medication to control level of uric acid.
Tuesday, May 8, 2007
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.
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.
Monday, May 7, 2007
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.
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.
Friday, May 4, 2007
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
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
Thursday, May 3, 2007
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
Wednesday, May 2, 2007
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.
Tuesday, May 1, 2007
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.
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.
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