Gout

Alternative names

• Hyperuricemia
• Asymptomatic Gout
• Acute Gout or Gouty Arthritis
• Interval and Intercritical Gout
• Chronic Tophaccous Gout

Symptoms

There are two different types of gout, primary gout and secondary gout. Primary gout is inherited, which consists of the over production of the uric acid in the blood, a decrease of uric acid in the urine, or both.

Secondary gout occurs when the medication causes the increase of uric acid in the blood. Diuretics can cause this. Kidney failure or the increased destruction of cells, such as cancer patients going through chemotherapy, are also attributed to secondary gout.

You will have redness of the joint accompanied by stiffness, inflammation, and extreme pain. Many will suffer from podagra, a condition where gout forms in the big toe, but you can also contract gout in other joints such as ankles, wrist, fingers, or elbows. 75 percent of first attacks start in the big toe.

Any type of pressure on the affected area hurts. Something as light as a bed sheet or your sock can cause extreme pain. Gout attacks can get better within a few days, even without treatment.

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Four Stages With Different Symptoms:

• Asymptomatic (without symptoms) Hyperuricemia are elevated levels of uric acid in the blood with no symptoms.
• Acute Gout or Gouty Arthritis is when deposits of uric acid crystals form in the joint spaces. Sudden onsets of pain will follow, along with swelling, heat, and tenderness.
• Interval or Intercritical Gout is the period in between attacks where there are no symptoms.
• Chronic Tophaccous Gout is the most severe and disabling of all stages of gout. It develops over years, causing permanent damage to any of the joints that are affected, and in some cases, the kidneys.

Causes

If there an increased production in uric acid and your kidneys are doing what they need to do to eliminate the acid, it will build up in the blood, a condition called Hyperuricemia. The uric acid forms tiny crystals the size of the point on a needle in the joints or soft tissue. The crystals can also form into kidney stones.

Risk factors

• Genetics makes up about 20% of all people who suffer from gout.
• Gender and Age: Gout is more common in adult men between the ages of 40 and 50, with a peak age of 75,
  are more likely to contract gout than woman, children, and young adults.
• Weight: Being overweight increases the risk contracting gout. The more you weigh, the more frequent the attacks. Having the extra weight makes it harder for the body to do its job. Losing the weight gradually willbe a benefit to those who have high levels of uric acid, even though being on a diet can trigger an attack.
• Alcohol: People that drink too much alcohol can contract gout as well. The more alcohol you drink, the more the blood is not able to remove the uric acid, the rest crystallizes. Gout attacks happen because the major consumption of alcohol impairs the kidney function.
• Lead: Some studies have concluded that there’s a strong connection between gout and lead poisoning.
• Other risk factors that can cause gout are certain foods such as anchovies, asparagus, beef kidneys, dried bean or peas, game meats, gravy, liver. There are so many others, but these are definitely the foods that gout sufferers should watch out for.
• The kidneys that possess an inability to eliminate waste products.
• People that suffer from high blood pressure.
• People who have had organ transplants.
• Hypothyroidism, or under active thyroid.

Prevention tips

• Medications: Non steroid anti-inflammatory drugs, or NSAIDs, help with the pain and inflammation, oral
• Colchicine in small does to prevent future attacks. Zyloprim and Benemid are medications that are used for the treatment of Hyperuricemia.
• Zyloprim can help in the management of uric acid, but it won’t stop an acute attack of gout that is already present. It can, however, reduce your symptoms when taken over the course of several months.
• People that use medication for high blood pressure and high blood triglycerides find that these meds can be used for the treatment of gout. Cozaar, a high blood pressure medication, and Tricor, a triglyceride lowering medication, are the two that have been found to help aid in the treatment of this condition.
• Lifestyle Changes: Controlling your weight keeps the body from having to work harder break down the bodily waste.
• Drinking large amounts of water removes uric acid from the body.
• Avoid diets that have a low-carbohydrate intake. When you’re not taking in a substantial amount of carbohydrates, the body can’t burn fat completely.
• Eating foods that are purine free is key to reducing the frequency of gout attacks. Purine free means that foods that don’t have a nucleus such as an egg. The yolk is the nucleus. They can’t be avoided completely because purines are released when the body recycles dead cells. These foods are egg whites milk and milk products like cottage cheese mozzarell and whey protein, and pulp-free fruit juices.
• When you have an attack, it is important to avoid excessive exercise, don’t starve yourself, and don’t reduce you calorie intake. The body will continue to break down body tissue and not getting the proper intake of calories per day, the body will compensate by accelerating the breaking down process.

Test and diagnosis considerations

To confirm a diagnosis, a doctor will inject a needle into the inflamed joint and pull a sample of the liquid that lubricates the joint called synovial fluid to analyze. If there are uric acid crystal found in the joint spaces, then you have gout. X-rays don’t work in the early stages of gout, only when the disease is in its later stage, will you see parts of the joint that have been worn away or eroded.

Patients will often seek medical attention thinking that finding the gout in its early stages will prevent it from getting worse later. Sometimes symptoms of gout can be confused with another form of arthritis. One form is called pseudogout. It resembles all the symptoms of gout, but instead of having uric acid crystals that form in the joint spaces, it calcium phosphate. In this case, pseudogout.

Treatment options

1. Home treatments

• Warming the joints with a foot bath and heating pad can help relieve joint pain.
• Increasing the amount of water that you drink will increase your urination, which decreases the amount of
  uric acid in your blood. According to the Institute of Medicine, men should drink approximately 13 cups of
  water per day, women should drink approximately nine cups, whether it’s in food or drink.
• NSAIDs, with the help of other prescribed drugs, are used to treat gout. Aspirin should not be taken
  because it can aggravate the condition.
• Corticosteroids can relieve pain and inflammation of gout in the joint by injecting it right into the joint if
  the pain medication that you have at home doesn’t work.
• Doctors have been advising patients who suffer from gout to take Vitamin E, B-complex, and folic acid to
  replenish the body’s supply.

This should be done under supervision of a physician, but a solution of half of a teaspoon of baking soda dissolved into a glass of water on an empty stomach. If the stomach is full, the combination of the stomach acid and the water/baking soda solution will turn the water into carbon dioxide gas.

The gas will increase stomach pressure, causing injury. Do not exceed more than seven 1/2 teaspoons or three 1/2 teaspoons if you’re over 60, in a 24 hour period. Don’t exceed the maximum dosage for more than two weeks.

Herbal Remedies

In folk medicine, eating or drinking cherries in various forms has shown to reduce the inflammation caused by gout. They have been promoted to the preventing or treating of the condition.

Other herbal remedies that people tend to use instead of conventional medicine are things like celery seed
oil, cherries or cherry extract, turmeric, artichoke extract, garlic, and various Chinese herbs.

Some people have found that swallowing a teaspoon of celery seed oil gives relief for people suffering from gout. It has been used as a herbal remedy to help with conditions where inflammation is a symptom and rheumatism. Turmeric is known in many countries for its health benefits. In Pakistan, it is used as an anti-inflammatory.

The herbal remedy Flamasil, which is turmeric based, it helps with the degeneration of cells, which is 70 percent of all uric acid production, enhances liver and kidney function, and blocks the enzyme that produces uric acid. With any home remedy or experimental drug, there will be opinions and criticisms about how well or if it works.

Side Effects

The side effects of oral colchicine is usually nausea, vomiting, abdominal cramps, or diarrhea. These side effects make it difficult for the patient to continue using the drug. Corticosteroids cannot be used for every attack you have. If used over time, it can cause deterioration of the joints. It can also decrease the ability for the body to fight off infection and may make these infections harder to treat. You might also notice an increase or decrease in appetite, nervousness, restlessness, problems sleeping, and indigestion.

If you’re using a corticosteroid, via inhalant, you’re more likely to suffer from dry throat as well as headaches, nausea, bruising and/or thinning of the skin, unpleasant sense of taste. Nasal sprays can also irritate the throat, and ointments or gels can cause skin irritation.

Probenicid, or Benemid, is not a good medication to treat acute gout attacks. They can aggravate the inflammation if used in the beginning stages of the attack. It can also cause kidney issues such as renal colic and increased levels of uric acid that can turn into uric acid stones, or kidney stones. Zyloprim side effects are included, but not limited to, an acute attack of gout, nausea, diarrhea, and certain skin reactions such as a rash.

All gout medications have side effects that range from nausea to stomach cramps. Although, there are new medications being developed in clinical trials that will substantially increase the elimination of uric acid and the lowering of uric acid in the blood stream. Researchers are also working on medications that will stop chemical messages that are causing the gout inflammation.

Chinese Research

In China, researchers have invented a medicine that compliments, the Weicao Capsule, that helps relieve gout, therapeutically. This is still in its trial phase, but it has been shown in a study that the capsule has increased urination, which lowers high levels of uric acid and improves kidney function.

Gout can become extremely serious if not treated in it’s earliest stages. There are some people that will dismiss the condition, but gout is very serious and has the capability of interfering with the simplest of everyday things.

Resources

National Institute of Health
Cdc.Gov
MedicineNet.Com