Cause of Gout

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Gout is caused by too much uric acid in the blood (hyperuricemia). Hyperuricemia usually does no harm, and most people with high levels of uric acid in the blood never develop gout. The exact cause of hyperuricemia sometimes goes undiscovered, although inherited factors (genes) seem to play a role. When uric acid levels in the blood are too high, uric acid may form crystals that accumulate in the joints. Gout can seem to flare up without specific cause or can be brought on by factors such as:

• Certain conditions related to diet and body weight, such as:
• Obesity.
• Moderate to heavy alcohol ingestion, particularly beer.
• A diet rich in meat and seafood (high-purine foods).
• Very low-calorie diets.
• Medications that may increase uric acid concentration, such as:
• Regular use of aspirin or niacin.
• Medications that reduce the amount of salt and water in the body (diuretics).
• Medications that cause rapid cell death (chemotherapy, usually used to treat cancer).
• Medications that suppress the immune systems, such as cyclosporine, that are used to prevent your body from rejecting an organ transplant.
• Major illness or certain medical conditions, such as:
• Rapid weight loss, as might happen in hospitalized patients who have changes in diet or medications.
• Chronic kidney disease.
• High blood pressure.
• Conditions that cause an abnormal rapid turnover of cells, such as psoriasis, multiple myeloma, hemolytic anemia, or tumors.
• Lead poisoning.
• Hypothyroidism.
• Surgery.
• Having been born with a rare condition that causes high blood uric acid levels. People with Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome have a partial or complete deficiency in an enzyme that helps to control uric acid levels.

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Gout Prevalence and Incidence

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According to the National Health and Nutrition Examination Survey III, 1988-1994, an estimated 5.1 million people in the United States suffer from gout.

Gout is the most common form of inflammatory arthritis in men. Gout affects approximately 3 times as many men as women, and men are more likely than women to have gout at all ages. Racial and ethnic differences are not as distinct among patients in the US, though African Americans aged 45 years or older are more likely to have gout than Caucasians in the same age group.

Some worldwide prevalence observations:

• Black Africans, Japanese, and Native Americans have generally lower levels than Caucasian populations.
• Compared to other populations, higher urate levels are found in adult ethnic men in Oceania.
• Ethnic groups in Malaysia and China have higher mean urate levels than most Caucasian populations.

In one longitudinal study, the cumulative incidence of all gout was 8.6% among men, with a median age at study entry of 22 years and a median follow-up of 29 years. In general, gout has an annual incidence of 1 to 3 per 1000 men. The rate in all women is approximately 1 in 5000; however, the incidence of gout in women increases after menopause.

There is also some evidence that the prevalence and incidence of gout appear to be rising. Multiple studies over the last 40 years have provided data consistent with a considerable increase in prevalence and annual incidence in Westernized industrial countries.

Asymptomatic hyperuricemia is the first stage in the development of gout. Although most individuals who have elevated serum urate levels do not develop gout, control of hyperuricemia becomes one of the primary goals of gout management once gout has been diagnosed.

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Another alternative medicine for gout discovered!!!

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Are you tired of having medicines from your doctor and you still haven’t seen the result of your drugs miracle works? Have your doctor prescribed several kinds of drugs to cure your gout? If your answer is ‘yes’ and if your gout treatments aren't working as well as you'd hoped, you may be interested in trying complementary and alternative treatments for your gout. You may consult to your doctor first about this medication. Your doctor can help you weigh the benefits and risks and tell you if the treatments will interfere with your gout medications.

These are some complementary and alternative treatments that have been studied and uncovered, so you may try this, include:

• Coffee. Studies have found an association between coffee drinking — both regular and decaffeinated — and lower uric acid levels, though no study has proved how or why coffee may have an influence on uric acid in your body. The available evidence isn't enough to encourage noncoffee drinkers to start, but it may give researchers clues to new ways of treating gout in the future.
• Vitamin C. Supplements containing vitamin C may reduce the levels of uric acid in your blood. However, vitamin C hasn't been studied as a treatment for gout. Don't assume that if a little vitamin C is good for you, then lots is better. Megadoses of vitamin C may increase your body's uric acid levels. Talk to your doctor about what a reasonable dose of vitamin C may be. And don't forget that you can increase your vitamin C intake by eating more fruits and vegetables, especially oranges.
• Cherries. Cherries have been associated with lower levels of uric acid in studies, but it isn't clear if they have any effect on gout signs and symptoms. Adding cherries and other dark-colored fruits, such as blackberries, blueberries, purple grapes and raspberries, to your diet may be a safe way to supplement your gout treatment, but discuss it with your doctor first.

Other complementary and alternative medicine treatments may help you cope until your gout pain subsides or your medications take effect. For instance, relaxation techniques, such as deep-breathing exercises and meditation, may help take your mind off your pain. But if you want to see another natural alternative medicine, just make sure you Check This out.

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Do You Know Gout;s Risk Factors?

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Gout is sometimes referred to as the “disease of kings” because it has long been associated erroneously with the kind of overindulgence in food and wine only the rich and powerful could afford. In fact, anyone can be affected and the risk factors are varied. Fortunately, it is possible to treat gout and reduce its agonizing attacks by avoiding food triggers and taking advantage of medication options.

To increase your awareness to gout, I make a list of risk factors that associated with hyperuricemia and gout. They include:

• genetics. Twenty percent of people with gout have a family history of the disease.

• gender and age. It is more common in men than in women and more common in adults than in children.

• weight. Being overweight increases the risk of developing hyperuricemia and gout because there is more tissue available for turnover or breakdown, which leads to excess uric acid production and causing hyperuricemia condition.

• alcohol consumption. Drinking too much alcohol can lead to hyperuricemia, because alcohol interferes with the removal of uric acid from the body.

• diet. Eating too many foods that are rich in purines can cause or aggravate gout in some people.

• lead exposure. In some cases, exposure to lead in the environment can cause gout.

• other health problems. Renal insufficiency, or the inability of the kidneys to eliminate waste products, is a common cause of gout in older people. Other medical problems that contribute to high blood levels of uric acid include:

– high blood pressure

– hypothyroidism (underactive thyroid gland)

– conditions that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic anemia, or some cancers

– Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps control uric acid levels either is not present or is found in insufficient quantities.

• medications. A number of medications may put people at risk for developing hyperuricemia and gout. They include:

– diuretics, such as furosemide (Lasix*), hydrochlorothiazide (Esidrix, Hydro-chlor), and metolazone (Diulo, Zaroxolyn), which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine

– salicylate-containing drugs, such as aspirin

– niacin, a vitamin also known as nicotinic acid

– cyclosporine (Sandimmune, Neoral), a medication that suppresses the body’s immune system (the system that protects the body from infection and disease). This medication is used in the treatment of some autoimmune diseases, and to prevent the body’s rejection of transplanted organs.

– levodopa (Larodopa), a medicine used to support communication along nerve pathways in the treatment of Parkinson’s disease.

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Blame Sweet Soda for Gout?

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For gout, sweetened soft drinks are worse than hard liquor -- and nearly as bad as beer -- doubling the risk for heavy drinkers. Diet sodas, however, don't affect gout risk.

The findings come from a huge study of 46,393 male health professionals in Canada who filled out detailed questionnaires about their health and their diet every four years for 12 years. Over that time, 755 of the men developed gout.

Compared with men who almost never drank sugar-sweetened soft drinks -- fewer than one per month -- frequent soft-drink drinkers were significantly more likely to suffer gout:

• Two or more soft drinks each day upped gout risk by 85%.
• One soft drink each day upped gout risk by 45%.
• Five or six soft drinks each week upped gout risk by 29%.

The men who drank the most soft drinks had twice the gout risk of the men who drank the fewest soft drinks.

That's comparable to the gout risk of men who drink two to four alcoholic beverages a day.

Beer raises gout risk by 49% per daily serving. A daily serving of spirits raises gout risk by 15%. Sweetened soft drinks, find University of British Columbia researcher Hyon K. Choi, MD, PhD, and colleagues, raise gout risk by 35% per serving.

"This is the first study -- and a very large one -- linking these commonly consumed products to this common disorder," Choi tells WebMD. "We find that if you have high consumption of fructose your gout risk is doubled. And that is due to easily available sugary beverages."

It's a surprising finding, says Karen Atkinson, MD, MPH, chief of rheumatology at the Atlanta VA Hospital and assistant professor of medicine at Emory University.

"It is a shock," Atkinson tells WebMD. "Most of us think of purine-rich foods as those that increase gout risk because they feed directly into the uric acid pathway. Certainly fructose processed by the liver can affect that pathway, but this is not what we usually think of."

Atkinson warns that while the Choi study definitely links soft drinks to gout risk, it does not prove that cutting back on soft drinks will lower that risk.

"But most doctors would agree that high-fructose carbonated beverages don't have any nutritional benefit. You don't want to be pouring high-fructose soft drinks into your body," she says.

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What Are The Signs and Symptoms of Gout?

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• Hyperuricemia (increased amount of uric acid in the blood)
• Presence of uric acid crystals in joint fluid. (these crystals are caused by high concentrations of uric acid)
• More than one attack of acute arthritis. (Gout and pseudogout are examples of crystal-induced arthritis, caused by an accumulation of crystalline material in various parts of the body)
• Arthrits that develops in 1 day, producing a swollen, red, and warm joint
• Attack of arthritis in only one joint, usually the toe, ankle, or knee (joints are junctions where two bones meet. Most joints are composed of cartilage, joint space, fibrous capsule, synovium, and ligaments)

Who Is Likely To Develop Gout?

Gout occurs in approximately 840 out of every 100,000 people. It is rare in children and young adults. Adult men, particularly those between the ages of 40 and 50, are more likely to develop gout than women, who rarely develop the disorder before menopause. People who have had an organ transplant are more susceptible to gout.

What Is The Prognosis For People With Gout?

With proper treatment, most people with gout are able to control their symptoms and live productive lives. Gout can be treated with one or a combination of therapies.

Treatment can reduce both the discomfort caused by the symptoms of gout and long-term damage of the affected joints. Treatment will help to prevent disability due to gout.

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10 things you should know about Gout

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Gout is considered one of the most painful types of arthritis. Along with pain, gout can cause swelling, redness, heat and stiffness in joints. There are other types of arthritis which can mimic gout symptoms, making it very important to get an accurate diagnosis so that proper treatment can begin. There are 10 things you should know about gout.

1 - Gout is accurately diagnosed through the identification of characteristic crystals.

Gout attacks develop when excess uric acid accumulates in the body and crystals are deposited in the affected joints. The big toe is often the first joint affected. A microscopic examination of joint fluid reveals the presence of monosodium urate crystals. Tophi, deposits of uric acid under the skin, also can develop, especially in advanced gout.

2 - Blood uric acid levels can be misleading.

During a gout attack, blood uric acid levels can be low or temporarily normal. Also, blood uric acid levels are often high (known as hyperuricemia) in people who do not have gout.

3 - Though the big toe is the most common joint affected by gout, ankles, heels, insteps, wrists, and knees can also be affected.

It's important to understand the stages of gout so you recognize when gout symptoms are affecting one of your joints:

• asymptomatic hyperuricemia - high level of blood uric acid without any symptoms of gout
• acute intermittent gout - one joint is painful, swollen, and hot, which without treatment may last 2 weeks or less (even less with treatment)
• chronic tophaceous gout - affected joint is uncomfortable and swollen much of the time; more than one joint may become involved; crystals begin to form tophi; kidney stones may develop

4 - Uric acid results from the breakdown of purines. Purines are part of all human tissue and found in many foods.

Excess uric acid can be caused by either an over-production of uric acid by the body or the under-elimination of uric acid by the kidneys. About 10 percent of people with hyperuricemia (high blood levels of uric acid) produce too much uric acid. More than 90 percent of people who have gout do not excrete enough uric acid in their urine.

5 - There are certain triggers which can cause a gout attack.

Among the potential triggers of gout attacks are:

• Medications which affect kidney function
• Loop and thiazide diuretics which alter kidney function
• Cyclosporine which is given to organ transplant recipients
• Low-dose aspirin can raise blood uric acid levels
• Urate-lowering drugs, such as allopurinol and probenecid (the sharp fall in uric acid can be a trigger)
• Obesity, hypertension (high blood pressure), hyperlipidemia (high blood fats), and diabetes
• Alcohol consumption
• Joint injury, surgical stress, acute medical illness
• Fad diets, fasting, and dehydration
• Lead exposure
• Body temperature (gout tends to form in colder body parts)

6 - For gout to be treated successfully, there are four goals of treatment.

To attain a successful treatment outcome for gout:

• acute attacks must be stopped
• pain and inflammation must be relieved quickly
• future attacks must be prevented
• tophi, kidney stones, and renal disease must be prevented

7 - Treating an acute gout attack can involve resting the affected joint and taking prescribed medications.

NSAIDs, and especially indomethacin, are commonly prescribed during an acute gout attack to control inflammation. Colchicine, a preferred treatment for acute gouty arthritis and most effective if given early in the attack, can provide pain relief within 48 hours. Prednisone or ACTH (adrenocorticotropic hormone) can be given to patients who cannot take NSAIDs or colchicine.

8 - To prevent future attacks, diet and lifestyle changes, along with urate-lowering medications, can be helpful.

Allopurinol is usually prescribed for people who over-produce uric acid and have tophi. Allopurinol blocks production of uric acid. Probenecid helps kidneys eliminate uric acid and is prescribed to patients with good kidney function, no history of kidney stones, who are willing to drink 2 liters of fluids on a daily basis. People who have chronic gout typically require lifetime treatment with drugs in order to lower uric acid levels.

9 - Prevalence statistics from the Arthritis Foundation indicate that 2.1 million Americans are affected by gout.

Gout actually accounts for 5 percent of all arthritis cases. Men who are 40-59 years old are the most likely group to develop gout. Women also can develop gout but usually not until after menopause. Gout is uncommon in children and young adults.

10 - Unless gout is properly managed it can affect the patient's life and work productivity.

One published study concluded that gout had a significant impact on work absence and work productivity. In the study, employees with gout had 4.56 more annual absence days than people without gout.

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Gout? What is it?

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Do you know what Gout is? if u don't, let me help you to introduce it.

Gout is a form of arthritis characterized by inflammation in a joint. The touch of a bedsheet or the sensation of a passing breeze on an affected joint can provoke excruciating pain for people suffering with gout.The most common site of an acute gout attack is the big toe. However, other joints can also be affected including the: ankles, knees, wrists, fingers, elbows.

Gout results from deposits of needle-like crystals of uric acid in connective tissue, joint spaces, or both. These deposits lead to inflammatory arthritis, causing swelling, redness, heat, pain, and stiffness in the joints. Gout accounts for about 5% of all cases of arthritis.

As you read above that the caused of Gout is the uric acid crystal. Uric acid is kind of metabolite from purines. Purines come from food and also breakdown of our DNA. So the main source of Gout is from food you eat than contained rich-purines.

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