Did you know that Gout is a type of inflammatory arthritis?
It affects 5% of men and 2% of women.
The most common symptom is podagra, a very painful inflammation of the big toe.
Today I’ll explain - What is the link between uric acid and gout?
- Can change in diet reduce gout attacks?
- Is there any medication to treat gout?
- Are these tophi nodules related to gout?
- Are exercises good for gout arthritis?
So, let’s talk about Gout today Before I continue, please remember that these
videos are for educational purposes only.
You should consult a physician to make the diagnosis and tell you which treatment is
indicated for you.
If there is an emergency, go to the nearest emergency department or call an ambulance.
A gout attack is a sudden accumulation of needle-like crystals in areas of the body
like the joints and the kidneys.
These needle-like crystals are formed because there is too much uric acid in the blood.
Why is there too much uric acid in the blood?
Well, it can be because there is too much formation of uric acid, or the elimination
of uric acid by the kidney is impaired.
Not everyone who has high levels of uric acid in their blood will develop gout.
Gout is more common in individuals older than 65 years, and their immune system will attack
these crystals and cause inflammation.
Uric acid comes from the breakdown of some high-protein food.
That is why we can lower the levels of uric acid by avoiding certain foods.
I’ll give a list later in this video.
These crystals can also deposit under the skin forming these bumps that we call tophi.
They can also accumulate in the kidneys causing kidney stones
Any joint of the body can be inflamed by a gout attack, but the most common ones are
the feet, ankles, and knees.
These attacks usually last around 1 to 2 weeks.
They start very suddenly with excruciating pain and disappear very suddenly too.
However, if they last longer than 2 weeks, we need to investigate and reduce the uric
acid levels in the blood, otherwise, they will have more and more attacks, and each
time, this inflammation may cause permanent damage to the joint.
So, how do we know if a joint pain, like an inflamed arthritis like this is gout or not?
The joint will be very red, swollen, hot and painful.
If necessary, we may do a joint aspiration with a needle, then we send the fluid to the
laboratory and we see these crystals inside of the joint.
These crystals have been accumuluating slowly inside of the joint, they don’t get there
suddenly, but what happens is that there is a trigger that makes the production of uric
acid spike, then this is what triggers this inflammation.
These triggers can be a protein-rich meal, a period of dehydration or drinking alcohol,
especially beer.
We may need to order an X-ray to see the extent of damage to the joint.
And also monitor the levels of uric acid in the blood to check if they are going down
with treatment.
So, how do we treat gout?
With proper treatment, very few patients will develop advanced stages of gout like this.
Most people who receive proper treatment early after the diagnosis will not even notice any
joint deformity.
Treatment for an acute attack Take an NSAID or a non-steroidal anti-inflammatory
drug.
I have another video about NSAIDs.
These medications will reduce the inflammatory response of your body to the crystals.
The NSAIDs will not eliminate the crystals from the joint.
Talk to your doctor or your pharmacist about the best NSAID for you.
There are various types and doses.
Here are some examples: ibuprofen, naproxen, diclofenac and indomethacin.
For people who cannot take an NSAID, there is colchicine, a medication that has been
used for more than 2,000 years which reduces inflammation.
Corticosteroids can also be used to reduce inflammation, either by injection or oral
pills.
During a gout attack the person may also apply ice.
I have another video about ice and cold.
Always protect the skin to avoid ice burns.
Leave the ice pack or pack of ice for about 20 minutes each time, and use 3 times a day.
Do not apply heat to reduce pain from a gout attack.
Now, I am going to talk about how to reduce uric acid levels.
This is important to stop the gout attack, but even more important to prevent future
attacks.
Because uric acid is produced from certain foods, it is important to avoid them:
- Processed meat - Red meat
- Organ meats like liver and tongue - Shellfish such as shrimp, lobster and mussels
- Oily fish like herring, sardines and mackerel - Sugary beverages including pops and juices
- Any food that contains corn syrup - Alcohol, especially beer
In the past, gout was known as the king’s disease.
It was more common in people who had high protein diets, beers and rare fish.
So, only the rich people could afford these meals and gout was more common among them.
There is another inflammatory arthritis, very similar to gout, it is called pseudogout.
It is caused by crystal deposits in the joint, but they are not urate cyrstals.
So, the treatment of pseudogout does not involve the same dietary restrictions because that
is not caused by uric acid crystals.
The main method to diagnose if the arthritis is caused by gout or pseudogout is to aspirate
the fluid from the joint and look at what kind of crystals are present in the fluid.
People who are obese and overweight tend to have more gout attacks.
So, it is important to maintain a healthy weigtht or a Body Mass Index (BMI) between
18.5 and 24.9.
Another important aspect is to remember to keep hydrated to avoid gout attacks.
If diet and lifestyle modifications are not enough to prevent gout attacks, there are
medications that can reduce uric acid levels.
Once the person starts taking these medications they need to stay on them for the rest of
their lives.
These medications include allopurinol and probenecid.
In people with chronic gout, there is permanent joint destruction and deposits of crystals
in the skin, these are called tophi And last, in people with gout, there is accelerated
joint destruction, and this leads to deformities and pain.
This is what we call osteoarthritis.
So, exercises are always the first choice treatment for osteoarthritis.
You need to remember the LAWS exercsies that I demonstrated in the video of hip and knee
osteoartrtitis.
L is for lubrication exercises, remember motion is lotion.
They help to warm up the joints, improve range of motion and break down any thick fluid.
You may do lubrication exercises in the morning before you get up from bed.
A is for aerobics, they are important to maintain a good cardiovascular system.
They also help to maintain a healthy weight.
They include walking, biking, dancing, and swimming.
Make sure to talk to your doctor and ask if you don’t have any restrictions to do cardio
exercises.
W is for weight-bearing exercises.
The main advantages are that they reduce pain and maintain calcium in the bones.
This is important to avoid osteoporosis.
Another condition that is very common in people with osteoarthritis.
S is for stretching.
This is important to maintain flexibility of the joints, to improve range of motion
and to reduce muscle tension.
I have other videos that I demonstrate exercises for osteoarthritis and the LAWS exercises.
In summary, gout is a disease that affects many older individuals.
The gout attacks can be extremely painful, but they can be avoided by restricting foods
that trigger the attack and keeping well hydrated.
If a gout attack occurs, they can use medications to reduce pain, apply ice or a cortisone injection.
It is also important to do some lifestyle modifications to prevent more gout attacks
and joint destruction.
If necessary, there are medications that the person can take to help them prevent future
gout attacks.
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Watch my next video here Good bye