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Gouty Arthritis is a form of arthritis that typically attacks suddenly and is characterized by repeated attacks of an extremely painful form of arthriti. Gout is the result of deposits of monosodium urate crystals. These needle-like crystals accumulate in the joints as the result of abnormally high uric acid levels in the blood (hyperuricemia).
Uric acid crystals are deposited on the articular cartilage of joints, on the tendons tendons, and on the surrounding tissues.
This results in one of the most painful rheumatic disorders.
Chronic inflammation as well as deformity can occur after repeated attacks, and nearly 20% of the people who have gout develop kidney stones.
Uric acid is a by-product produced by the body when it metabolises cellular materials. Both as a result of the body breaking down its own cells and replacing them and as the result of our diet nearly all of the foods we eat are composed of what were living cells that lead to the production of uric acid in a greater or lesser degree. The uric acid level becomes abnormally high if the kidneys are unable to eliminate enough from the urine. Some cases are the result of the production of large amounts of uric acid because of a hereditary enzyme (inborn errors of purine-pyrimidine metabolism) abnormality and diseases such as blood cancer, in which cells multiply and are rapidly destroyed. Some types of kidney disease and certain drugs impair the kidney's ability to eliminate uric acid. People that are prone to gout are also more likely to suffer attacks as a result of surgery and wounds.
Acute gouty arthritis happens with no warning . It may be started because of a small injury, surgery, consumption of large quantities of alcohol or protein-rich food, fatigue, emotional stress, or illness. Usually , Very strong pain can ocur suddenly in one or more joints, often at night; the pain often becomes excruciating. The pain is so intense that the sufferer may not be able to stand even the lightest sheet draped over the affected area. The joint swells and the skin over the joint appears red or purplish, tight, and shiny. And it feels warm. Touching the skin over the joint can be extremely painful.
The disorder most often affects the joint at the base of the big toe, causing a condition called podagra, but it also commonly affects the instep, ankle, knee, wrist, and elbow. Crystals may form in these peripherally located joints because they are cooler than the central part of the body and urate tends to crystallize at cooler temperatures. Crystals also form in the ears and other relatively cool tissues. In contrast, gout rarely affects the spine, hips, or shoulders.
Other symptoms of acute gouty arthritis can include fever, chills, a generally sick feeling, and a rapid heartbeat. Gout can be more severe in people who develop symptoms before age 30. Usually gout develops during middle age in men and after menopause in women.
The first few attacks usually affect only one joint, and last for a few days. The symptoms gradually disappear, the joint's function returns, and no symptoms appear until the next attack. Some people never have another attack between six months and two years after the first. After attacks, other joints may become involved, accompanied by constant pain as the result of joint damage from chronic inflammation. If Gout is permitted to progress, untreated attacks last longer and happen more often, possibly affecting several joins. These may become permanently damaged as a result.
One of the more serious complications that can occur are tophic formation. After years of hyperuricemia, (gout) permanent deposits of uric acid crystals may be formed in and around joints. These are called "Tophi" and can lead to disabling deformities and permanent damage to the kidneys.
Another is the formation of kidney stones these stones are made of 80% calcium, with the rest of various substances, including uric acid, cysteine, and struvite.
And a risk of kidney failure crystals, protein, or other substances in the kidney can lead to kidney failure
If left untreated, tophi on the hands and feet can erupt and discharge chalky masses of crystals.
Uric acid is metabolized by the system from protein foods with purine Foods that are high in purine and protein, All foods based on living cells have purines to a lesser or greater degree. Particularly animal liver and other organ meats
sardines
wine
heavy alcohol consumption
poultry
Lists are available that can advise the gout sufferer about the particular foods that need to be avoided.
People with gouty arthritis typically have hypertension and impaired renal function, Therefore examination of the renal and cardiovascular systems is absolutely necessary. The Baseline lab tests should include a complete cell count, urinalysis, and serum creatinine, blood urea nitrogen (BUN) and serum uric acid measurements.
Gout is often diagnosed on the basis of its distinctive symptoms and an examination of the joint. A high uric acid level in the blood supports the diagnosis; however, this level is often normal during an acute attack. The diagnosis is confirmed when needle-shaped urate crystals (intracellular monosodium urate crystals) and polymorphonuclear leukocytes are identified in synovial fluid, aspirated with a needle and viewed under a special type of microscope that uses polarized light.
By examining the aspirated joint fluid other disorders ca be ruled out that may seem like gout, like septic arthritis which is an infection in the synovial fluid caused by bacteria, or pseudogout. This is a disorder that is characterized by intermittent attacks of painful arthritis that is caused by deposits of calcium pyrophosphate crystals. Occasionally, patients with gout may present without uric acid crystals in the synovial fluid aspirate. However, aspiration repeated five hours to one day later shows crystals in the synovial fluid.
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What is treatment for gouting?
There are a couple medications that lower uric acid levels. You'll need a doctors prescription and you'll need to drink plenty of water. Certain foods result in elevated uric acid. Those too can be avoided to help with the gout. Gout results when uric acid crystalizes in a joint. It can cause damage to the joint and it can take a little while to dissolve, even when you are taking the medication. If you are a person who tends toward elevated uric acid, you should probably take the medication for the rest of your life, but that's something that your doctor should help with. It's pretty important that you take the medication, since uric acid crystals can also build up in your kidneys, resulting in permanent damage. Gout is a type of inflammation of the joints and swellings. It is more common in men than in women. Excessive alcohol, Stress and lack of exercise are the common factors of gout. Apples are considered to be an excellent source for curing gout. Bananas are also recommended for the treatment of gout. Basically all natural fruit diet are considered best for gout. 1. Lemon Juice Gout is a build up of too much acid in the body. Therefore the body's pH level must be neutralized by adding alkaline to the body. This is best achieved by drinking the juice of a fresh lemon. Lemons are 20% acid, 80% alkaline. I just take the juice of a whole lemon, mix it with warm water in a tumbler and down it through a straw. Doing this first thing in the morning on a empty stomach also helps cleanse the kidneys which is linked to other gout related problems. 2. Cherries Prior to taking lemon juice every day, if I felt a gout attack coming on, I would go and buy a kilo of cherries and gradually munch on them for a few hours. Cherries are a natural anti-inflammatory. 3. Diet and Exercise While the first two points are excellent treatments, a healthy balanced diet and exercising 3 times a week for 45 minutes is core to preventing gout from occurring in the first place. Fad diets are rubbish. Dieting is pretty simple. It's pretty obvious what's healthy and not: Things that grow out the ground and that are natural = good. Things in colourful packets with loads of e-numbers and weird looking animations promoting them = bad. Moderation is the key.A Low Purine Diet is aso a good way to limit the incidence of gout. Here is a list of some of the foods that are high in purines. These foods have the highest concentration of purines and should therefore be avoided by people that are prone to or are already suffering from gout. Beef, Pork, Bacon, Lamb, Seafood, Foods that are made with yeast like beer or bread, Alcoholic Beverages These foods, while high in purine levels that can aggravate the symptoms of gout can be had occasionally by those who usually follow a low purine diet. Asparagus, Cauliflower, Mushrooms, Peas, Spinach, Whole grain breads and cereals, White poultry meats, like chicken, duck or turkey, Kidney and lima beans. The following foods are safe to eat in a low purine diet; however these should not be the only food you eat. Green vegetables and tomatoes, Fruits and fruit juices, Breads that do not use yeast (may be found in the kosher section or a health food store), Nuts, Milk and milk products such as butter and cheese, Chocolate, Coffee and tea.
