GOUT – WHAT IS IT AND HOW TO DEAL WITH IT.

I have gout.  Especially in my left big toe. Gout can be crippling if you don’t know how to deal with it. In this series I will try to cover ways to deal with it.

Some of you may have gout and have gone undiagnosed for years. I know I did. I had such a pain in my big toe that it made it hard to walk and eventually made it almost impossible to walk. What is gout?

Gout is a painful form of arthritis. It occurs when high levels of uric acid in the blood causes crystals to form and accumulate around a joint. And it is produced when the body breaks down a chemical called purine that naturally occurs in our body. However, it is also found in many foods sources. Gout causes extreme pain in the joint that worsens in response to minimal pressure, inflammation (swelling, warmth, and tenderness) of the joint, and sometimes can cause fever and/or peeling of the skin around the joint.

Gout can go undiagnosed by doctors. I myself went to several doctors who kept telling me they could find nothing wrong with my foot. Apparently Gout and the developing crystals surrounding the joint, will not show up on an X-ray. In order to properly diagnose gout, you must have your doctor test your blood for uric acid. Uric acid levels exceeding 10mg/dL makes it very possible to develop gout.

In the normal healthy body, uric acid is eliminated from the body in urine. However, sometimes we can get such a build up of uric acid in the body that the body finds it hard to eliminate it.

A diet, specially formulate for  gout patients, may help decrease uric acid levels in the blood. While a diet made for gout is not a cure, it may lower the risk of recurring painful gout attacks and slow the progression of joint damage. Medication also is needed to manage pain and to lower levels of uric acid.

Diet details

A balanced diet is the best defense against gout. Being a meat and potato person, I know the struggle of balancing my diet. I naturally crave meat and potatoes but not so crazy about fruits and vegetables. But, a balance diet is a must. So if you aren’t so crazy about veggies, find ways to make them taste better. There are recipes out that that make even broccoli taste like a treat. My favorite is Broccoli Salad; it is yummy. Here are some diet tips recommended by the Mayo Clinic:
  • Weight loss. Being overweight increases the risk of developing gout, and losing weight lowers the risk of gout. Research suggests that reducing the number of calories and losing weight — even without a purine-restricted diet — lowers uric acid levels and reduces the number of gout attacks. Losing weight also lessens the overall stress on joints.
  • Complex carbs. Eat more fruits, vegetables and whole grains, which provide complex carbohydrates. Avoid foods such as white bread, cakes, candy, sugar-sweetened beverages and products with high-fructose corn syrup.
  • Water. Keep yourself hydrated by drinking water. An increase in water consumption has been linked to fewer gout attacks. Aim for eight to 16 glasses of fluids a day with at least half of that as water. A glass is 8 ounces (237 milliliters). Talk to your doctor about appropriate fluid intake goals for you.
  • Fats. Cut back on saturated fats from red meats, fatty poultry and high-fat dairy products.
  • Proteins. Limit daily proteins from lean meat, fish and poultry to 4 to 6 ounces (113 to 170 grams). Add protein to your diet with low-fat or fat-free dairy products, such as low-fat yogurt or skim milk, which are associated with reduced uric acid levels.

Uric acid can be lowered by taking medication. There are several prescription medicines used to treat gout. However, your doctors goal should be to prescribe medication that will lower uric acid in your body.  The most common is allopurinol.  This is the medicine I was prescribed and it works great for me. To see a list of prescription drugs that are commonly prescribed for gout, visit this website: https://www.drugs.com/condition/gout.html.

While Allopurinol can reduce the amount of uric acid in your system, reducing chances of further damage to your joint, 0ver the counter medications can help with the pain and inflammation. The best to use is Ibuprofen because it treats both the pain and inflammation. However, if you are like me and can’t take ibuprofen, Aleve (naproxen) is a good substitute. Aleve is an over-the-counter (OTC), nonsteroidal anti-inflammatory (NSAID) pain reliever that provides temporary relief of minor aches and pains from a variety of conditions. It also temporarily reduces fever. Naproxen sodium, 220 mg. Aleve contains 200 mg of naproxen and 20 mg of sodium(salt). Resistant gout attack or inflammation may require oral or injection of corticosteroid into the joint to relieve pain.

Gout-cartoon-myth-police-lineup-300x287

Gout can affect any joint in the body, but it is most commonly found in the big toe. Gout can also develop during a course of another disease, such as:

  • obesity
  • diabetes mellitus
  • hypertension or high blood pressure
  • sickle cell anemia
  • kidney or renal disease
  • hyperuricemia caused by breakdown of nucleic acids
  • myeloproliferative and lymphoproliferative diseases
  • psoriasis
  • hemolytic anemia (premature destruction of red blood cells, causing anemia or inadequate number of circulating red blood cells).

If you look at the diseases in bold, these are the diseases I have and most likely what contributed to my gout, along with my poor diet of meat and potatoes. Eating vegetables and fruit is very important to prevent gout or any further damage by gout.

Gout CAN get worse. So don’t brush it off as something you have to endure. Get help now. Change your eating habits as well. According to “Health In Plain English” has four main stages:

Stages of Gout

Gout has 4 stages:

asymptomatic

acute

intercritical

chronic

In asymptomatic gout, the blood levels of uric acid rise but symptoms have appeared yet.

Normally, uric acid is dissolved in the blood, filtered by the kidneys, and passed out through urine. But, in people who have developed gout,this process goes hay wire. This can happen when too many purine-rich foods are eaten. Some foods high in purine include, liver, dried beans, mushrooms, and peas. In other cases, your kidneys don’t remove enough uric acid from the body.

Uric acid accumulates in the blood, causing a condition known as hyperuricemia. And even though you may not notice any symptoms, your body is being damaged.

In the acute stage is marked with painful joints. At this stage, needle-shaped crystals start developing around the damaged area.

gout-diag-opt

The intercritical period are symptom-free intervals between gout attacks. This can last months or even years – however most people have their second attack within 6 months to 2 years. In some cases, the second attack does not occur for 5 to 10 years.

Left untreated, the second gout attack usually last longer and is more severe than the first one. It can also be polyarticular or affect multiple joints, usually the joints in the feet and legs, and can be accompanied by a fever.

Secondary gout attack can also “migrate” that is sequentially attacking various joints, including the Achilles tendon. A condition called bursitis or inflammation of the bursa (a sac containing joint lubricating fluids) can also be present.

In the last stage, chronic gout affects multiple joints all the time. In this stage, pain at multiple joints persists and large lumps of uric acid deposits called tophi (singular:tophus) are present. Chronic inflammation and the presence of tophi in the joints can accelerate joint degeneration, which can lead to deformity and disability.

In advanced chronic gout, damage to the kidney caused by uric acid deposit can cause kidney failures. Other conditions, such as hypertension (high blood pressure), albuminuria (abnormal presence of albumin protein in the urine indicating kidney disease), and urolithiasis (urinary stone in the urinary tract) can also develop.

gout-surgery

In advanced gout, surgery may be the only option. The tophi are excised, drained to improve joint functions and any deformity is corrected.

 

 

 

 

 

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