When a patient has gout, they will most likely be very
uncomfortable, and possibly be limping as they approach. Gout used to be known
as the rich man’s disease, since it was presumed gout is often caused by red
wine and expensive cuts of meat. We now
know that gout can affect any number of people.
What is Gout?
Gout is a form of inflammatory arthritis that develops in
some people who have high levels of uric acid in the blood. The acid can form
needle-like crystals in a joint and cause sudden, severe episodes of pain,
tenderness, redness, warmth and swelling.
What Are The Different Types of Gout?
There
are several stages of gout:
Asymptomatic
hyperuricemia is the period prior to the first gout attack. There are no
symptoms, but blood uric acid levels are high and crystals are forming in the
joint. Acute gout, or a gout attack,
happens when something (such as a night of drinking) causes uric acid levels to
spike or jostles the crystals that have formed in a joint, triggering the
attack. The resulting inflammation and pain usually strike at night and
intensify over the next eight to 12 hours. The symptoms ease after a few days
and likely go away in a week to 10 days. Some people never experience a second
attack, but an estimated 60% of people who have a gout attack will have a
second one within a year. Overall, 84% may have another attack within three
years.
Interval
gout is the time between attacks. Although there’s no pain, the gout isn’t
gone. Low-level inflammation may be damaging joints. This is the time to begin
managing gout – via lifestyle changes and medication – to prevent future
attacks or chronic gout.
Chronic
gout develops in people with gout whose uric acid levels remain high over
a number of years. Attacks become more frequent and the pain may not go away as
it used to. Joint damage may occur, which can lead to a loss of mobility. With
proper management and treatment, this stage is preventable.
Gout
occurs in about 4% of American adults – about 6 million men and 2 million
women.
Gout Risk Factors:
- Genes: If family members have gout, you’re more likely to develop it.
- Other health conditions: High cholesterol, high blood pressure, diabetes and heart disease may raise your risk.
- Medications: Diuretic medications or “water pills” taken for high blood pressure can raise uric acid levels; so can some drugs that suppress the immune system taken by rheumatoid arthritis and psoriasis patients, as well as transplant recipients.
- Gender and age: Gout is more common in men than women until around age 60. Experts believe natural estrogen protects women up to that point.
- Diet: Eating red meat and shellfish increases your risk.
- Alcohol: For most people, more than two liquor drinks or two beers a day can increase the risk of gout.
- Sodas: The fructose in sweet sodas has recently been shown to increase gout risk.
- Obesity: Obese people are at a higher risk for gout, and they tend to develop it at a younger age than people of normal weight.
- Bypass surgery: Those who have undergone gastric bypass surgery have an increased risk.
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Treating Gout
Few things in life
are more painful than a gout attack, so if you’re awakened in the wee hours by
a joint that is tender, swollen, red and radiating heat, you’ll want to act
fast. Here’s what you can do when a gout attack starts to ease the pain of the
attack and reduce the risk of others.
Take medicine you
have on hand: Start
treatment immediately with over-the-counter ibuprofen (Motrin, Advil)
or naproxen (Aleve), but never take aspirin, which can actually
worsen an attack. If you have had an attack before and your doctor has
prescribed an anti-inflammatory medication to take in the event of another, take
your prescribed medication as your doctor directed. If you are already taking a
uric acid-lowering drug to reduce the risk of attacks, continue to take that
drug through this attack.
Ice down: Applying an
ice pack to the painful joint may help ease pain and inflammation. Wrap a pack
(a bag of crushed ice or frozen peas will also do) in a dish cloth and apply to
the area for 20 to 30 minutes at a stretch several times a day. Getting treatment within the first 24 hours
of the start of an attack can lessen its length and severity. Drink plenty of fluids. Staying
hydrated helps flush out uric acid (the
cause of your joint pain) and prevent kidney stones, another possible problem
associated with high uric acid levels. Aim for eight to 16 cups of fluids
a day, at least half of them water.
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