Who Is Affected By Gout
Gout can affect anyone. It usually occurs earlier in men than women. It generally occurs after menopause in women. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. Women reach these uric acid levels after menopause.
People are more likely to get gout if they have:
- Obesity, or a lot of extra weight.
You are also more likely to develop gout if you:
- Consume a diet high in animal proteins
- Consume a significant amount of alcohol
- Are on water pills .
How Is Gout Diagnosed
Your health care provider will get your complete medical history and do a physical exam. She may run these exams and tests to diagnose gout:
- Ajoint fluid analysis to see if uric acid crystals are present. This is the only certain way to diagnose gout.
- Tests to measure uric acid levels in blood and urine
There are many conditions with symptoms similar to gout. Be sure to see your doctor for a diagnosis.
Time To Call The Doctor
A gout attack will usually go away in about 3 to 10 days. But you can feel better sooner if you treat it. To be sure that you have gout, see your doctor. Theyâll examine you, and they might do some tests.
These test help your doctor know if you have gout, or something else with similar symptoms:
- Joint fluid test. Fluid is taken from the painful joint with a needle. The fluid is studied under a microscope to see if the crystals are there.
- Blood test. A blood test can check the level of uric acid. A high level of uric acid doesnât always mean gout.
- X-ray. Images of the joints will help rule out other problems.
- Ultrasound. This painless test uses sound waves to look for areas of uric acid deposits.
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How Does A Doctor Diagnose Gout
If you have sudden or severe pain in a joint, you should talk to your primary care provider . Your PCP may send you to a rheumatologist, a doctor who specializes in gout and other kinds of arthritis.
Healthcare providers consider several things when confirming gout:
- Symptoms: The provider will ask you to describe your symptoms, how often they happen and how long they last.
- Physical examination: Your provider will examine the affected joint to look for swelling, redness and warmth.
- Blood work: A test can measure the amount of uric acid in your blood.
- Imaging tests: You may have pictures taken of the affected joint with X-rays, an ultrasound or MRI.
- Aspiration: The provider may use a needle to pull fluid from the joint. Using a microscope, a team member can look for uric acid crystals or a different problem .
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Points To Remember About Gout
- Gout is a type of arthritis that causes pain and swelling in your joints, usually as flares that last for a week or two, and then go away.
- With early diagnosis, treatment, and lifestyle changes, gout is one of the most controllable forms of arthritis.
- The most common symptom of gout is pain in the affected joint, such as the big toe.
- Your doctor may recommend taking medications to manage the cause of your gout and treat active gout flares, and making changes to your diet and lifestyle.
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How Is Gout Treated
Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to
- Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
- Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food , may help prevent future attacks. Changing or stopping medications associated with hyperuricemia may also help.
- Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.
In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.
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What Causes Gout Flare Ups & How To Get Rid Of It
Gout is a common condition that affects many people. It is painful and the first flare ups of gout can be shocking. Gout flare ups are actually painful inflammation of the joints. They are caused by the uric acids. The uric acids are sharp needle like crystals that build up in the bone joints. Though many people think that the gout flare ups occur out of nowhere, they are actually caused by a number of factors that trigger the condition over time. Amongst these, the most common ones are certain foods, medicines, drinks and sometimes, even stress can be a major cause.
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Black Tea Contains Oxalate
A study published in Urological Research in 2009 looked at gout patients who had calcium oxalate urinary stones and gout patients who did not. They determined theres a likely relationship between gout and calcium oxalate stones due to the change in uric acid metabolism in gout patients. The University of Maryland Medical Center recommends cutting back on foods that contain oxalate, including black tea. According to a study published in the Asia Pacific Journal of Clinical Nutrition in 2002, the amount of oxalate present in it is small compared to amounts in many foods in a typical diet. However, if you add milk to your black tea, the oxalate in the tea can bind to the calcium in the milk, increasing your risk of calcium oxalate stone formation.
Fact: Not Having Symptoms Doesnt Mean Your Gout Is Gone For Good
Gout attacks typically last one to two weeks and then subside. Some people can go months before getting another gout attack others may get them more frequently. If gout is not properly treated such as with taking medication to reduce uric acid levels gout attacks can start to occur more frequently and affect more joints.
In between gouts attacks, you may have no painful symptoms and feel more or less fine. But your uric acid levels may still be high, which is why its important to stick to your treatment plan: If you are on a uric acid-lowering drug, you have to continue to take it every day, says Nilanjana Bose, MD, MBA, a rheumatologist at the Rheumatology Center of Houston in Texas. If you start and stop it, your uric acid fluctuates, and thats the perfect setup for another gout flare.
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The Four Stages Of Gout
Gout is best understood by seeing it as having four phases or stages :
Stage 1: High uric acid
Elevated uric acid without gout or kidney stone, this stage has no symptoms and is generally not treated.
Stage 2: Acute flares
This stage is marked by acute gout attacks causing pain and inflammation in one or more joints.
Stage 3: Intercritical periods
These are periods of time between acute attacks, during which a person feels normal but is at risk for recurrence of acute attacks.
Stage 4: Advanced gout
This is a stage of chronic gouty arthritis, in which there are lumps of uric acid, or tophi , frequent attacks of acute gout, and often a degree of pain even between attacks .
Figure 1: Stages of Gout
Figure 2: Illustration of Toe Joint with Gouty Tophus. normal toe joint Urate crystals, shown in white, at the âbunion joint,â represent a gouty tophus.)
Figure 3: Progression of Gout
Does Coffee Cause Gout
Coffee on its own doesnt cause gout. The main reason for gout is the build-up of uric acids that cause inflammation in the joints.
The study on the Coffee Consumption May Lower Blood Uric Acid Levels The Precursor of Gout showed that coffee consumption is associated with lower uric acid levels. However, caffeine isnt the sole contributor to this benefit. All the components in the coffee produce this unique blend of fighting gout.
Although the majority of study has revealed the beneficial properties of coffee for gout, there are still certain risk factors that need to be considered.
For example, age, obesity, family condition, certain health condition, alcohol consumption, etc all contribute to the risk of gout. Even if coffee can prevent the risk, its a stimulant and you cant depend on the drink on the regular basis.
Too much coffee will make you feel anxious or hit you with a severe headache. These side effects of caffeine overdose may risk your symptoms of gout.
Some common symptoms of gout include:
- Inflammation and redness in the affected area
- Intense pain or swelling in the joint
- Discomfort in the affected joint
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Coffee Consumption May Lower Blood Uric Acid Levels
Arthritis Care Research News Alerts. 2007 57:816-821.
High uric acid levels in the blood are a precursor of gout, the most common inflammatory arthritis in adult men. It is believed that coffee and tea consumption may affect uric acid levels but only one study has been conducted to date. A new large-scale study published in the June 2007 issue of Arthritis Care & Research examined the relationship between coffee, tea, caffeine intake, and uric acid levels and found that coffee consumption is associated with lower uric acid levels but that this appears to be due to components other than caffeine.
Coffee is one of the most widely consumed beverages in the world more than 50 percent of Americans drink it at the average rate of 2 cups per day. Because of this widespread consumption, its potential effects have important implications for public and individual health. Led by Hyon K. Choi, of the University of British Columbia in Vancouver, Canada, the current study was based on the U.S. Third National Health and Nutrition Examination Survey, conducted between 1988 and 1994. It included over 14,000 men and women at least 20 years old who consented to a medical exam in which blood and urine specimens were obtained. Coffee and tea consumption were determined based on responses to a food questionnaire that assessed intake over the previous month. Researchers estimated the amount of caffeine per cup of coffee or tea using data from the U.S. Department of Agriculture.
Literature Search And Study Characteristics
The flow chart for the identification of the included studies was presented in Fig. . A total of two hundred and seventy four potentially relevant publications were retrieved during the initial literature search. After eliminating eighty duplicated articles, one hundred and ninety four articles were identified for detailed evaluation. One hundred and nineteen studies were excluded initially. Then, sixteen reviews, case reports or letters, forty two non-human studies, and two articles without full-text accessibility were removed . All of the excluded articles are listed in Additional file . Eventually, ten cross-sectional, one casecontrol and four cohort studies were included in this systematic review and meta-analysis. Eleven, five and two studies were related to the associations of tea consumption with the SUA level, HU and the risk of gout, respectively. Table summarizes the main characteristics of these fifteen included studies. The methodological qualities of these studies were shown in Additional file : Table S1 , Table S2 and Table S3 .
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Ten Tips For Beating Gout
If you have gout, use these nutrition tips to lower your risk:
See your GP to check or monitor gout risk factors
Drink up to four cups of regular or decaffeinated coffee a day
Have two to three serves of reduced-fat or skim dairy foods daily
Eat cherries regularly . Add to breakfast cereal and snacks, or mix with yoghurt
Avoid fasting and feasting. Both increase purine turnover and blood uric acid
Risk Factors And Potential Causes Of Gout
Gout strikes men more often than women until women undergo menopause, and then women experience increased risk. Being overweight or obese, having recent surgery, and experiencing a trauma also increase your risk, as well as your family history.
Your body produces uric acid when it breaks down purines a substance found naturally in your body, and also in high-protein red meat, organ meat, and certain types of seafood. In addition, alcoholic drinks, beer, and beverages sweetened with fructose can raise your natural uric acid levels. When your body either creates too much uric acid or excretes too little, it can lead to gout. Hundreds of years ago, gout was called the disease of kings because the average peasant couldnt afford such rich food and drink.
Medical conditions like untreated high blood pressure, diabetes, heart disease, and kidney disease can also increase your chances of developing gout, as does taking certain medications, such as thiazide diuretics and low-dose aspirin.
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Bacteria Is Not Always What You Think It Is
But, of course, when we hear the word bacteria we imagine something awful.
Disease. Contagion. Illness. Death.
Because mostly we associate bacteria with being very ill.
Theyre something to fight off the moment we get them.
We buy products from our supermarket that boast how quickly and effectively they kill bacteria.
But bacteria are just single-celled organisms that can be found just about anywhere.
Some are dangerous. Some are highly beneficial.
It depends which bacteria they are. And it depends on where they are.
Those that exist within us within our gut microbiome are largely beneficial to us.
In fact, in a healthy human being some 95% of them are responsible for a number of vital body processes that either keep us healthy or keep us alive.
Yes. Theyre that important.
We are, in fact, extraordinarily dependent on the health of our microbiome.
So much about us on the surface our health, our moods, our body weight reflects whats going on in the gut.
Incredibly, scientists are now recognizing that the microbiome our gut bacteria is so vital to our general health that some think of it as an organ in its own right.
They regard it as important to our existence as the kidneys or the heart or the lungs.
In fact, scientists are able to transplant the gut bacteria from a healthy person into the gut of a diseased patient in order to cure disease.
Bacteria transplants whod have thought it?
Its really hard to overstate how important our gut health is to us.
Caffeine And Gout Risk
Studies show that caffeine may protect you from gout because caffeine is similar in chemical structure to a common gout medication. But other research shows that increasing your caffeine intake can actually trigger gout pain in fact, one study found that suddenly doubling your caffeine intake could increase the risk of gout symptoms by up to 80 percent. So if you are a coffee or tea drinker, caffeine could be helping protect you just remember that a sudden binge could bring on a gout attack.
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Reduce The Pressure Reduce The Pain
Gout cant be cured, but it can be managed effectively and ensuring that your feet receive expert care plays an important part in that process.
Our London podiatrists can help to relieve the pain caused by gout in your big toe with prescription orthotics. These custom-made shoe inserts are designed to make the affected area more comfortable by reducing the pressure its under. Whats more, we can offer expert advice on which shoes youll find most comfortable.
Podiatric padding and foot shields can be beneficial when gout strikes. In addition, if the swelling has led to sores, ulcers, calluses, etc., we can treat those issues too.
For expert help to relieve the foot pain caused by gout, please call Feet By Pody today on 0207 099 6657 or book a podiatry appointment online.
Myth: Once You’ve Got Gout Lifestyle Changes Don’t Really Help
Truth: Lifestyle changes can reduce both the severity and frequency of attacks. For starters, when people lose weight, they often have fewer attacks, says Reveille.
Animal proteins have a higher level of purines, so it’s better to eat vegetable proteins like beans and peas.
In fact, a 2010 review in the rheumatology journal Current Opinion in Rheumatology notes that protein-rich foods such as dairy products, nuts, beans, peas and whole grains are healthy choices for people with gout, reducing the risk of heart disease and possibly lowering the risk of insulin resistance.
Baraf says that he asks patients to abstain from alcohol during the first six months of treatment, until medications have stabilized uric acid levels. After that, he says, it’s fine to drink in moderation.
Dorothy Foltz-Gray is a freelance writer who lives in North Carolina.Remember to go to the AARP home page every day for tips on keeping healthy and sharp, and great deals.
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Myth: If You Stay Away From Liver And Alcohol You’ll Avoid Gout Attacks
Truth: Alcoholic drinks especially beer and organ meats such as liver and some fish, including anchovies and sardines, are very high in a class of natural substances known as purines. When the body breaks down purines it creates uric acid, so eating a lot of purine-rich foods does increase the risk of an attack. But while avoiding these foods may reduce attacks, it won’t halt them, says Reveille.
Gout can be life threatening if left untreated.