Symptoms and Treatment for Gout or Joint Swelling
Gout is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that deposit in tissues of the body, especially the joints. When crystals form in the joints, it causes recurring attacks of joint inflammation (arthritis). Gout is considered a chronic and progressive disease. Chronic gout can also lead to deposits of difficult piles of uric acid in the tissues, particularly in and around the joints and may cause joint destruction, decreased kidney function, and also kidney stones (nephrolithiasis).
Gout has the unique distinction of being one of the most frequently recorded medical illnesses throughout history. It is often associated with an inherited abnormality in the body's ability to process uric acid. Uric acid is a breakdown product of purines which are part of many foods we eat. An abnormality in managing uric acid can cause attacks of painful arthritis (gout attack), kidney stones, and also blockage of the kidney-filtering tubules with uric acid deposits, leading to kidney failure.
On the other hand, some people may only develop elevated blood uric acid levels (hyperuricemia) without having manifestations of gout, such as arthritis or kidney problems. The state of elevated levels of uric acid in the blood without symptoms is referred to as asymptomatic hyperuricemia. Asymptomatic hyperuricemia is considered a precursor state to the development of gout. The definition of gout refers the disease that is caused by an overload of uric acid in the body, resulting in painful arthritic attacks and deposits of lumps of uric acid crystals in body tissues.
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Gouty arthritis is usually an extremely painful attack with a rapid onset of joint inflammation. The joint inflammation is actually precipitated by deposits of uric acid crystals in the joint fluid (synovial fluid) and joint cellular lining (synovial lining). Intense joint irritation occurs as the immune system responds, causing white blood cells in order to engulf the uric acid crystals and chemical messengers of inflammation to be introduced, leading to pain, heat, and redness of the joint tissues. As gout progresses, the attacks of gouty arthritis usually occur more frequently and often in additional joints.
Symptoms of Gout:
The small joint at the base of the big toe is the most common site of a serious gout attack of arthritis. An acute attack of gouty arthritis at the bottom of the big toe is medically known as podagra. Other important joints that are commonly affected include the ankles, knees, wrists, fingers, and elbows. Acute gout attacks tend to be characterized by a rapid onset of pain in the affected shared followed by warmth, swelling, reddish yellowing, and marked tenderness. Tenderness can be intense so that even a blanket touching the skin over the affected joint can be unbearable. Individuals can develop fever with the acute gout attacks. These painful attacks usually subside in hours to days, with or without medication. In rare instances, another panic attack can last for weeks. Most patients with gout get each year repeated attacks of arthritis over the years.
Uric Acid Uric Acid can Deposit in Tiny Fluid-Filled Sacs (Bursae) Around the Joints
These urate crystals can incite inflammation in the bursae, leading to pain and swelling around the joints (a condition called bursitis). In rare instances, gout leads to a more chronic type of joint inflammation that mimics rheumatoid arthritis.
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Chronic (tophaceous) gout, nodular masses of uric acid crystals (tophi) deposit in different soft-tissue areas of the body. Even though they are most commonly observed as hard nodules around the fingers, at the tips of the arm, in the ear, and around the big toe, tophi nodules can appear anywhere in the body. They have been noted in unexpected areas such as in the vocal cords or (rarely) even around the spinal cord. When tophi appear in the tissues, the gout condition is actually felt to represent an amazing overload of uric acid within the body.
Treatment for Gout:
There are two key concepts important to treating gout. First, it is critical to quit the acute inflammation of joints affected by gouty arthritis. Second, it is important to address the long-term management of the disease in order to prevent future gouty arthritis attacks and shrink gouty tophi very deposits in the tissues.
The treatment of an acute attack of gouty arthritis involves measures and medicines that reduce inflammation. Preventing future acute gout attacks is equally as important as treating the acute arthritis. Prevention of acute gout involves maintaining sufficient fluid intake, weight reduction, dietary changes, reduction in alcohol consumption, and medications to lower the uric acid level in the bloodstream (reduce hyperuricemia).
Maintaining Adequate Fluid Intake Helps Prevent Severe Gout Attacks
Adequate fluid intake also decreases the risk of kidney stone formation in patients with gout. Alcohol is known to have diuretic effects that can give rise to dehydration and precipitate acute gout attacks. Alcoholic beverages can also affect uric acid metabolism to cause hyperuricemia. Therefore, alcohol has two major effects that intensify gout by impeding (slowing down) the excretion of uric acid from the renal system as well as by causing dehydration, both of which contribute to the precipitation of uric acid crystals in the joints.
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