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Writer's pictureSam Bhide

GOUT?


🔺Gout is a common type of inflammatory arthritis that presents as sudden pain, swelling, inflammation ( warm/hot and red) joints.


🔺Gout is caused by build up of uric acid in and around the joints resulting in crystals or tophi formation



🔺Mostly seen in great toe, but can also affect other joints such as foot, ankle, knees, fingers, elbows, knees , wrist, hands and shoulders.


🔺Predominantly seen in Males above 30 years of age > Females ( menopausal age)


RISK FACTORS


  1. Genetics- Family history of Gout or increased uric acid levels

  2. Obesity or high body weight

  3. Diet- excess sugar intake, alcohol, meat and seafood

  4. Medications- Occasionally if on low dose aspirin etc

  5. Gender- Male, menopausal women

  6. Conditions- Chronic kidney disease, high blood pressure, Diabetes Type II


DIAGNOSIS


🔸Examination- red, swollen joint over night & tophi formation( swelling of the joint)

🔸Blood test- serum urate levels- >360 micromol/L (6 mg/dL) confirms Gout


🔸If joint is swollen aspiration is suggested, speak to your healthcare professional



MANAGEMENT


💊Acute case- Anti inflammatory medication ( naproxen) + omeprazole to reduce inflammation for the flare up


💉Steroid injection - For joint pain and inflammation


💊Colchicine is also recommended for flare up management


🩸Measure urate levels 4-6 weeks after flare up settles down


💊Long term - Allopurinol or Febuxostat ( medication) is suggested to manage the uric acid levels


🥗Diet and lifestyle advice- reduce alcohol 🥃intake, 🚭quite smoking, reduce 🥩intake of red meat, seafood (purine rich foods) , exercise to reduce weight and maintain a healthy lifestyle by regular exercise 🏃‍♀️


Purine rich foods-


Shellfish, including anchovies , crab, lobster, oysters and shrimp sardines, herring, mussels, codfish, scallops, trout and haddock .


Meats, such as bacon, turkey, veal, venison and organ meats like liver , beef, chicken, duck, pork and ham 










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