How Do I Know If I Have Gout

How Do I Know If I Have Gout – Here’s what to expect at each stage of the disease and how to prevent gout flare-ups.

Gout is a type of inflammatory arthritis that occurs when the level of uric acid, a normal product of metabolic reactions in the body, becomes too high. When the amount of uric acid is so high that your body cannot easily dissolve it and remove it (in urine), the uric acid begins to crystallize. Uric acid crystals settle in the joints, where they cause severe inflammation. The big toe is a well-known site for gout attacks, but gout can affect many different joints throughout the body.

How Do I Know If I Have Gout

How Do I Know If I Have Gout

Gout is one of the oldest recorded diseases reported in ancient Egypt. This extremely painful arthritis affects millions of American adults today, as it did in historical times, as memorably described by Dr. Thomas Sydenham in the 17th century:

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– The victim goes to bed and sleeps soundly. About two o’clock in the morning he is awakened by a severe pain in his toe; less often in the area of ​​the heel, ankle or calf…The pain, which was mild at first, becomes more and more intense…The sensation of the affected area is so wonderful and alive that the person cannot bear it. bedding or glass enters the room.”

Fortunately, gout is one of the most treatable forms of arthritis today—some rheumatologists say it can be cured. However, many gout patients remain untreated or untreated. For example, in a recent study, only 37 percent of people with gout took the uric acid-lowering drug allopurinol; among gout patients with frequent flare-ups, only half used it.

If gout is treated incorrectly, the disease can progress. Over time, gout can begin to affect multiple joints throughout the body, causing problems such as gout and permanent bone damage.

Learn more about how gout develops, how gout progresses through the different stages, and how to treat gout to prevent symptoms, reduce uric acid levels, and prevent long-term gout complications.

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Also called asymptomatic hyperuricemia, in this early stage of gout, uric acid builds up in the blood and crystals begin to form around the joints, usually in the legs.

Uric acid is produced when your body breaks down substances called purines, which are produced in your body and are also found in some foods and drinks. Although eating foods high in purines can increase uric acid levels, many experts believe that the role of diet in the development of gout is overstated. Chronic uric acid levels build up when your kidneys can’t get rid of uric acid effectively, which can happen for a number of reasons, including:

“In this early stage of gout, a person doesn’t have joint pain, joint pain or swelling, just a blood test for elevated uric acid,” says Theodore R. Fields, MD, FACP, a rheumatologist at the Hospital for Special Surgery. New York. “This is the time when uric acid or urate crystals build up in the joints and can later cause inflammation.

How Do I Know If I Have Gout

However, high uric acid alone is not enough to diagnose gout. “Most people with hyperuricemia never develop clinical gout,” says Alireza Meysami, MD, FACR, FACP, a rheumatologist at Henry Ford Health System in Michigan.

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“This is when a person has pain, redness and swelling in a joint, usually a big toe, foot, ankle or knee, but gout can also start in other joints,” says Dr. Fields. “That’s when the urate crystals are released into the synovial fluid and cause an inflammatory reaction, bringing in lots of white blood cells and releasing inflammatory chemicals that cause pain, redness and swelling.”

If you think you’re having a gout attack, see your primary care doctor or rheumatologist and get treatment started. It is important to see a doctor during a gout attack because the doctor may want to remove the fluid from the affected joint and look at it under a microscope to check for uric acid crystals. The detection of uric acid crystals in the synovial fluid helps to confirm the diagnosis of gout.

After the first gout flare, 75 percent of people will have a second one within a year; however, some people may go several years before having another attack, says Dr. Fields. The middle stage is “when a person has had gout before, but currently has no joint pain or swelling,” he says. “Almost all patients with gout go through this phase, because the nature of gout is to flare up and then subside for a period of time before the next flare-up.”

Although it may seem like nothing is happening, patients must begin long-term treatment. Reducing uric acid levels with medication can prevent future gout flare-ups and their associated long-term complications.

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This stage is also called “localized gout” because the uric acid deposits can form nodules called “tophis”, often on the big toe or elbow. However, tophi can form anywhere on the body. “At this stage, a person can have almost constant joint pain from gout,” says Dr. Fields. “It usually takes years of uncontrolled smoking to get to that stage.”

At this stage, progressive joint damage develops, so patients with gout should be treated before this. “Delaying treatment can make gout worse,” says Dr. Meysami.

As you become more familiar with the symptoms of gout, you may notice a gout attack. “Increasing pain, swelling, redness, and warmth in the affected joint during a seizure is a sign of the seizure’s progression,” says Dr. Meysami.

How Do I Know If I Have Gout

In addition, the disease can typically progress through “recurrent or more frequent prolonged gout attacks with multiple joint involvement and tophi,” says Dr. Meysami.

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If you have more than one gout attack a year, it’s important to take your gout medication regularly, Dr. Fields says.

Gout usually progresses without treatment. In addition, certain factors can cause gout flare-ups. “Anything that causes a sudden increase or decrease in urate levels can cause gout,” says Dr. Fields.

This may include eating foods high in purines that break down into urates, such as red meat and shellfish. Foods high in fructose can also increase the body’s production of urate. Alcohol reduces the excretion of uric acid in the urine, which can lead to an increase in uric acid levels. First of all, “beer not only has an alcohol effect on uric acid in the urine, but it also contains a protein that breaks down into purines and then into urates, increasing urate levels in two ways,” says Dr. Fields.

While you may want to limit foods high in purines to prevent flare-ups, both doctors we spoke to said diet alone is not enough to control gout. “Strict purine restriction in the diet is rarely recommended because it only reduces mean serum [blood] urate levels by 1 mg/dL, which is insufficient for most patients,” says Dr. Meysemi.

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Gout was once called the “disease of kings,” but it was mistakenly thought to be caused by rich food and drink. “Gout is a genetic disease where your body excretes too much urate in the urine or produces too much urate, and it’s not a disease caused by diet,” says Dr. Fields. “For gout flare-ups, watching your diet can certainly help, but you almost always need medication to suppress the genetic predisposition to gout.

So, if you find that certain foods trigger your gout symptoms, avoid them. “Consumption of alcoholic beverages or rich food can trigger gout attacks in some patients, and every patient should avoid triggers that are known to trigger attacks,” says Dr. Meysemi.

However, one of the risk factors for gout is obesity. In fact, gout has become more common recently, probably due to the rise in obesity. “Weight loss in obese people will have a greater urate-lowering effect than a purine-free diet,” says Dr. Meysemi. To this end, a healthy diet and exercise can help you lose weight and reduce the likelihood of disease progression.

How Do I Know If I Have Gout

Emotional stress can also trigger a gout attack. Physical trauma to the foot (which can happen while running) can also dislodge some of the crystals and cause an inflammatory reaction.

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“We don’t discourage people with gout from running or exercising,” says Dr. Fields. “However, if someone has gout in the foot, ankle or knee, we recommend staying away from the foot as much as possible, as further trauma to the joint with a gout flare can prolong the flare.

Initiation of a treatment regimen may also inadvertently trigger an exacerbation; however, other medications may be prescribed to help reduce this risk.

Fortunately, due in part to its long history, gout is one of the best understood and most medically treatable forms of arthritis.

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