Health Care and Gout

In days gone by, gout was considered to be the “disease of kings” largely because those who usually had this malady were very wealthy or royalty. The primary thought was that only rich individuals developed gout because only they could afford the food and drink that led to this health care problem. Actually, there is no substantive connection as anyone could develop gout regardless of their social status. However, there are certain dietary conditions related to this health issue.

Gout is a kind of arthritis that occurs when uric acid builds up in blood and causes joint inflammation, according to the National Institutes for Health (NIH). Here are some symptoms:

• Acute gout is a painful condition that typically affects one joint.
• Chronic gout is repeated episodes of pain and inflammation, which may involve more than one joint.

Gout, according to the NIH, is caused by having higher-than-normal levels of uric acid in your body. This may occur if:

• Your body makes too much uric acid
• Your body has a hard time getting rid of uric acid

If too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed. The exact cause is unknown. Gout may run in families. It is more common in men, in women after menopause, and those who drink alcohol. People who take certain medicines, such as hydrochlorothiazide and other water pills, may have higher levels of uric acid in the blood. The condition may also develop in people with:

• Diabetes
• Kidney disease
• Obesity
• Sickle cell anemia and other anemias
• Leukemia and other blood cancers

The condition may occur after taking medicines that interfere with the removal of uric acid from the body. More information is available at this site: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001459/ .

Acute gout will typically manifest itself as an acutely red, hot, and swollen joint with excruciating pain, according to the Centers for Disease Control (CDC). These acute gouty flare-ups respond well to treatment with oral anti-inflammatory medicines and may be prevented with medication and diet changes. Recurrent bouts of acute gout can lead to a degenerative form of chronic arthritis called gouty arthritis. Weight loss lowers the risk for gout. More info can be found at this site: http://www.cdc.gov/arthritis/basics/gout.htm .

According to the CDC, gout can be viewed in four stages:

o Asymptomatic tissue deposition occurs when people have no overt symptoms of gout, but do have hyperuricemia and the asymptomatic deposition of crystals in tissues. The deposition of crystals, however, is causing damage.

o Acute flares occur when urate crystals in the joint(s) cause acute inflammation. A flare is characterized by pain, redness, swelling, and warmth lasting days to weeks. Pain may be mild or excruciating. Most initial attacks occur in lower extremities. The typical presentation in the metatarsophalageal joint of the great toe (podagra) is the presenting joint for 50% of people with gout. About 80% of people with gout do have podagra at some point. Uric acid levels may be normal in about half of patients with an acute flare. Gout may present differently in the elderly, with many joints affected.

o Intercritical segments occur after an acute flare has subsided, and a person may enter a stage with clinically inactive disease before the next flare. The person with gout continues to have hyperuricemia, which results in continued deposition of urate crystals in tissues and resulting damage. Intercritical segments become shorter as the disease progresses.

o Chronic gout is characterized by chronic arthritis, with soreness and aching of joints. People with gout may also get tophi (lumps of urate crystals deposited in soft tissue)—usually in cooler areas of the body (e.g., elbows, ears, distal finger joints).

The big toe is the most common target, but gout can attack the feet, ankles, knees, and hands as well, according to Health Magazine online. An attack or “flare” can last for days or months. Men and obese people are at greater risk. If you’re prone to gout, the foods you eat—and don’t eat—play a key role in keeping your joints pain-free. Find a lot of material at this site: http://www.health.com/health/gallery/0,,20448674,00.html .

According to a lot of web based material, there are many reasons why anyone suffering from gout should consult their primary care physician or a medical provider for care and treatment of this disease. If not treated properly, more severe complications can result. Always talk with your doctor if you suspect you may be seeing symptoms that appear to be gout related. Consider what options are available, and find out what medications may be good for you. Also, think about your diet, as some foods can cause an increase in uric acid that can lead to gout. Prevention and disease maintenance go a long way to help with this disease.

Until next time.