Gout

Gout: Description, Causes and Risk Factors:GoutGout is a type of arthritis. A disorder of purine metabolism, occurring especially in men, characterized by a raised but variable blood uric acid level and severe recurrent acute arthritis of sudden onset resulting from deposition of crystals of sodium urate in connective tissues and articular cartilage; most cases are inherited, resulting from a variety of abnormalities of purine metabolism. The familial aggregation is for the most part galtonian with a threshold of expression determined by the solubility of uric acid.Types may include:Abarticular gout.
  • Articular
  • Calcium
  • Idiopathic
  • Interval
  • Latent
  • Lead
  • Masked
  • Primary
  • Retrocedent
  • Saturnine
  • Secondary
  • Tophaceous
Gout is often divided into four stages:Asymptomatic hyperuricemia.
  • Acute gouty arthritis.
  • Intercritical
  • Chronic tophaceous
Causes and Risk Factors:Many foods contain purine molecules (A colorless crystalline organic base containing nitrogen; the parent compound of various biologically important substances). Along with amino acids (which make up proteins) and other molecules, purines are a source of nitrogen for your body. When purines are processed they are broken down into uric acid so that the body can get rid of some of the nitrogen. In some people uric acid is not processed properly and the levels in the bloodstream can get too high. When this happens, the molecules can form small crystals that deposit in joints, causing a painful arthritis known as gout.The following high purine foods are known to cause a gout attack or make gout worse: Shellfish (shrimp, clams, crab, lobster, mussels, scallops), sardines, meat broth, large amounts of pork or beef, organs meats (brain, kidney, liver, sweetbreads, tongue), dried beans peas, asparagus, spinach and mushrooms.Risk Factors:Drinking too much alcohol can lead to hyperuricemia because it interferes with the removal of uric acid from the body.
  • Positive family history.
  • Exposure to lead in the environment can cause gout.
  • Diuretics, which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine may some time increase the chance of getting gout.
Scientific studies have confirmed the long-held belief that consumption of cherries can be beneficial and there is some recent research to suggest that the risk of developing gout is reduced in people eating a diet rich in dairy products.Symptoms:Gout typically strikes the joint of the big toe, but may affect other joints, such as the ankle or knee.Common symptoms of gout may include:Limited movement in the affected joint. Diagnosis:The first step in diagnosing the disease is to determine which joints are affected. A physical examination and medical history can help confirm or rule out gout.Because patients with gout typically have hypertension and impaired renal function, examination of the renal and cardiovascular systems is essential. Baseline laboratory tests should include a complete blood cell count, urinalysis, and serum creatinine, blood urea nitrogen and serum uric acid measurements.Tests may include:Joint x-rays.
  • Synovial (joint) fluid analysis.
  • Uric acid blood test.
  • Uric acid urine test.
Treatment:Serum uric acid concentrations may be reduced with nonpharmacologic therapy. Useful dietary and lifestyle changes include weight reduction, decreased alcohol ingestion, decreased consumption of foods with a high purine content, and control of hyperlipidemia and hypertension. Used alone, however, these measures will probably not reduce serum uric acid levels to normal, which is the treatment goal for the prevention of gout attacks. Symptomatic hyperuricemia usually requires medication. Patients should drink plenty of water or other fluids to reduce the risk of kidney complications.Three treatments currently available for gout attacks are nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and corticosteroids. Medicines used to treat gout may include:Allopurinol (the most commonly used)
  • Probenecid.
  • Sulfinpyrazone.
Risks and benefits must be discussed with the physician.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.Reference and Source are from:DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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