basic information on gout

basic information on gout

Gout is a condition in which the body has a problem in the handling of uric acid. People with gout either produce too much uric acid or more commonly their bodies have a problem in removing it. There are a number of possible consequences of this build up of uric acid in the body, including acute and chronic gouty arthritis, kidney stones, and deposits of uric acid in subcutaneous and other tissues (tophi). Gout may occur alone (primary gout) or may be associated with certain medical conditions or medications (secondary gout). Gouty arthritis should be considered in people who have a sudden onset of a hot, red, swollen joint. It is diagnosed by finding uric acid (monosodium urate) crystals in the joint fluid. These crystals can accumulate over the years in the joint and trigger repeated bouts of inflammation. If left untreated, the accumulated crystals can damage the joint and lead to chronic arthritis. Fortunately, there are effective medications to treat gout. Gout Causes Uric acid is generated as the body's tissues are broken down during normal cell turnover. Some people with gout generate too much uric acid (10%). Other patients with gout do not effectively eliminate their uric acid into the urine (90%). Genetics, gender, and nutrition (alcoholism, obesity) play key roles in the development of gout. * If your parents have gout, then you have a 20% chance of developing it. * British people are 5 times more likely to develop gout. * American blacks, but not African blacks, are more likely to have gout than other populations. * Use of alcohol, especially beer, increases the risk for gout. * Diets rich in red meats, internal organs, yeast, and oily fish increase the risk for gout. * Uric acid levels increase at puberty in men and at menopause in women, so men first develop gout at an earlier age (30s to 50s) than do women (50s to 70s). Gout in pre-menopausal women is distinctly unusual. Approximately one million people in the United States suffer from attacks of gout Attacks of gouty arthritis can be precipitated when there is a sudden change in uric acid levels. 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. Anyone who has a sudden onset of a hot, red, swollen joint should seek medical care, either with a primary care physician or at an emergency department. It is important to make an accurate diagnosis of gouty arthritis, but these symptoms can also be due to an infection in the joint. If you have been diagnosed with gout and have more than one attack of arthritis, you should take the medication prescribed by your physician for these attacks. You should be seen by your physician or in the emergency department if your attack does not respond to this treatment. You may need medications to prevent further arthritis flares. Attacks of abdominal pain due to kidney stones (renal colic) may also be related to gout. Approximately one million people in the United States suffer from attacks of gout.
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