The Average Weight Of A Turkey Purchased At Thanksgiving Is Gout – Painful Crystals in Your Joints

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Gout – Painful Crystals in Your Joints

Gout is often called the “disease of kings.” It was noticed many years ago that gout often affects the nobility and the wealthy. This study was a result of the richer diet available to wealthy people at the time. Today, most of us eat like “kings”. Illness shows rare economic discrimination. It occurs when uric acid, a waste product of normal protein breakdown that is normally dissolved in the blood serum, builds up in the joints and severely irritates the lining. The skin is often red on the joints during the attack. Most common in men from 40 to 60 years. It is rare for women until after menopause. Several joints may be involved, but usually only one is affected at a time. The joints of the large base, knees, hips or ankles are mainly affected.

It occurs more often in men when the kidneys are unable to remove uric acid quickly enough when it builds up in the blood. In addition, it may be due to excessive consumption of purine protein products. Declining kidney function as you age is part of the normal aging process. When the amount of uric acid increases significantly, some of it passes from the blood into the joint fluid forming long needle-shaped crystals. The shape of the needle represents what the patient often experiences during the attack of a million needles in the joint with excruciating pain. Even the skin of the joints is often red due to infection. It is often the day after holidays such as Thanksgiving, Christmas, Easter because of the increase in food and alcohol.

The doctor can generally be sure of the disease by listening to the patient and examining them. Many diseases and other types of arthritis can mimic gout. Therefore, it may be necessary to remove some of the fluid from the joints. The fluid should be examined under a special microscope and tested to confirm the disease.

A blood test for changes in blood acidity may help make a diagnosis. However, 30% or more of people with an attack will have normal serum uric acid at the time of the doctor’s office visit. After the first attack, other blood and urine tests may be needed to determine the cause of the uric acid. The level of uric acid can change for other diseases that can lead to inflammation, but not primary gout.

A marked attack of joint pain often brings the patient to the doctor’s office. If it’s really severe, the intravenous fluid “washout” process begins. Medicines that remove the crystals from the joints can be given orally or intravenously in the most severe cases. About 80% of people are allergic to it when given orally. Steroids (cortisone or prednisone type of medicine) can be given either as injections, pills, or injected directly into the joint to further reduce inflammation.

Non-steroidal anti-inflammatory drugs (NSAIDs) are the mainstay of treatment for acute attacks. People with a history of ulcers or stomach problems may do better with one of the newer NSAIDs that are gentler on the stomach. IV medication can stop the flare-ups and keep you out of the office for an hour.

About three-quarters of people who have an attack will have a second attack within 2 years without treatment and lowering of uric acid levels. It will almost never go away without major changes. Those who do have an attack can develop chronic pain and permanent changes in the joints. You and your doctor need to avoid this. It is necessary to determine the actual cause of crystallization. Other tests may be needed to determine the exact cause of the problem, including a sample of intra-articular fluid. Medicines, especially diuretics (“water pills”) are often used to treat high blood pressure. Medicines can interfere with the production or elimination of uric acid. Changing medications can help prevent relapse. High blood pressure, diabetes, low thyroid, and other diseases greatly increase the risk of an attack. The risk of another attack is greatly reduced due to disease control and uric acid control. Being overweight, using too much alcohol or caffeine, being dehydrated or eating too much purine can increase the risk of another attack. Allopurinol and other medications can be used to reduce acid reflux. The drug must be given with caution because sudden changes can cause severe attacks.

Review all medications with your doctor. Find out which medications may help with your attacks. Regular use of aspirin can cause you to develop ulcers. Alcohol is the only substance that both increases the production of uric acid and decreases its elimination. Reducing or eliminating the use of alcoholic beverages can completely prevent another attack. Increase your fluid intake–your water intake. Caffeinated or alcoholic beverages cause dehydration, not rehydration, and are therefore counterproductive. As we age, our awareness of dehydration decreases. By the time we feel thirsty, we are already more than “one liter down”. People with gout need to get into the habit of drinking replacement fluids throughout the day. Always tell your doctor about your problems. By being careful, your doctor can avoid medications that can increase your uric acid levels and the precipitation of crystals.

Obesity contributes to the formation of crystals. Being overweight increases the amount of water in the body, and this leads to dehydration. Fasting can trigger an attack. Discuss your new diet with a nutritionist and doctor. Diets high in fat and protein are often effective in helping people lose weight. Eating a lot of fat increases the risk of an attack. Liver, kidney and sweet bread are high in uric acid. Cold meats (lunch meat) and processed meats, including hot dogs, sausages and offal, are problematic. White meat, especially turkey and pork, contains more acidic ingredients than red meat. Occasional portions of these foods usually won’t cause you to have an attack. However, regular consumption of these meats increases your chances of developing crystals. A general moderate intake of meat with a well-balanced diet and increased hydration is best for you. Drink plenty of water.

An exercise program is an important part of any weight loss program. Overdoing it in the weight room, or doing heavy muscle work can cause muscle strain. Excessive exercise increases uric acid levels. Decreased exercise causes severe pain and dehydration. Diet and lifestyle changes and working with your doctor can reduce the problem and save your joints from long-term damage.

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