About Gouty Arthritis Attacks ( COUERECY ;- MEDICINE NET )
Gout -
What Is Gout?
Gout is one of the most
frequently referenced medical disorders in the history of mankind. Gout is the
result of an abnormality of the body's ability to process uric acid. Uric acid
builds up either because of too much uric acid intake (from rich foods such as
chocolate, seafood, or red wine) or the body's inability to process it. The
uric acid then crystalizes in the joints - mainly the toes, ankles, hands and
wrists - causing the painful inflammation of a gouty attack (gouty arthritis).
In severe cases, increased uric acid can cause kidney stones and blockages of
the kidney filtration system (tubules), and permanent damage to the kidney or
even kidney failure.
Who Is Affected by Gout?
Gout
is more common in men than in women. It is also more common later in life with
most patients having attacks after the age of 50. If your parents have gout
then you are also at increased risk of getting gout yourself.
What Are the Risk
Factors of Gout?
Risk factors for gout
include:
·
Obesity
·
Excessive weight gain
·
Moderate to heavy
alcohol intake
·
High blood pressure
·
Abnormal kidney function
Some medications such as
diuretics (water pills), and having low thyroid hormones may also be risk
factors for getting gouty attacks.
What Are Symptoms of Gout?
The
large joint at the base of the big toe (first metatarsalphylangeal joint) is
the most common site for a gout attack, however, any other joint can be
affected. Most commonly other joints affected are the ankles, knees, wrists,
fingers, and elbows.
Patients
with gout attacks suffer a rapid onset of pain in the affected joint followed
by swelling, redness, and severe tenderness. Some experience pain so intense
that even the light touch of a bed sheet on the joint is excruciating. These
painful attacks can last from hours to several days. In cases of chronic
inflammation the attack may last for weeks. Unfortunately, patients with gout
are at risk for repeated attacks of gouty arthritis.
Gout (Big Toe)
The
large joint at the base of the big toe (first metatarsalphylangeal joint) is
the most common site for a gout attack but other joints commonly affected are
the ankles, knees, wrists, fingers, and elbows.
Gout (Fingers)
Inflamed
lumps of tissue may form in the joint with repeated bouts of gout or prolonged
cases. These lumps are called tophi.
Gout (Elbow)
Some
of the larger joints of the body have a fluid-filled sac around them that act
as a shock absorber called a bursa. A bursa also helps with the movement
mechanics of the joint. If gout causes inflammation and swelling of the bursa
it is called bursitis.
What Procedure Is Used to Diagnose Gouty
Arthritis?
Gout
is usually diagnosed by a doctor based on the location of the inflamed joint
and a history of having similar non-traumatic attacks of pain and swelling. The
most reliable (but not always necessary) test for confirming gout is an
arthrocentesis. Arthrocentes is a procedure where fluid is withdrawn
(aspirated) from an inflamed joint with a needle and syringe, using a sterile
technique and a local anesthetic such as lidocaine. The fluid is sent to a lab
where it is analyzed for the presence of uric acid crystals.
How Is Gout Diagnosed?
The
fluid withdrawn by an arthrocentesis is analyzed in a lab under a microscope
for the presence of uric acid crystals. The fluid analysis can also rule out
other causes of inflammation including bacterial infections.
What Do Uric Acid Crystals Look Like?
Needle-like
uric acid crystals are best viewed with a microscope.
How Are Gout Attacks Prevented?
Staying
well hydrated is the best way to prevent gout attacks. Drink plenty of water
throughout the day. Proper hydration also decreases the risk of kidney stones
or kidney dysfunction as a result of built-up uric acid.
Avoid
alcohol or only drink in extreme moderation if you have had gout attacks in the
past. Alcohol affects the body's metabolism of uric acid and can cause it to
build up (hyperuricemia). If levels of uric acid build up in your system it can
precipitate a gout attack in your joints.
Additional Prevention Techniques
Foods
rich in purines such as shellfish or organ meats (liver, kidneys, brains,
sweetbreads) can lead to gout attacks. The body converts purines into uric
acid, which in turn leads to gout attacks.
Overall
weight reduction is also a way to avoid gout attacks. A diet low in fats and
calories, combined with a regular exercise regime can help decrease the
likelihood of a gout attack.
What Are the Medical Treatments for Gout?
Gout
is a very painful condition. Pain relievers and anti-inflammatory medications
are the mainstay of treatment for gout. Nonsteroidal anti-inflammatory drugs
(NSAIDs), colchicine (Colcrys), and corticosteroids are used to decrease joint
inflammation.
Other
medications such as probenecid (which helps the body excrete excess uric acid)
and allopurinol (Zyloprim, Aloprim), (which decreases the amount of uric acid
formed by the body) are used for managing the underlying metabolic derangement
that causes hyperuricemia and gout. These medicines decrease the elevated
levels of uric acid in the blood.
What Does the Future Hold for Gout?
Research
is ongoing to find new strategies to prevent gout. New drugs are being
developed to keep the body from having high uric acid levels and decrease the
likelihood of a painful gout attack.
Reviewed by Kirkwood Johnston, MD
on Thursday, July 14, 2016
Gout Attack Symptoms,
Causes, Treatment, and Diet
This tool does not
provide medical advice.
মন্তব্যসমূহ
একটি মন্তব্য পোস্ট করুন