Gout: Understanding, Preventing, and Managing a Common Form of Arthritis.

Gout is a form of arthritis characterized by sudden, severe attacks of pain, redness, and swelling in the joints, often the big toe. It occurs when uric acid crystals accumulate in the joints due to high levels of uric acid in the blood. Gout can be triggered by certain foods, alcohol, stress, or other health conditions and is typically managed with medication and lifestyle changes.

1. GOUT Submitted by : s. Nahidha begum (BP231518) Submitted to : Mrs. P. Amudhanila dept . Of microbiology

2. GOUT A type of inflammatory arthritis characterized by sudden and severe joint pain, often in the big toe, due to the buildup of uric acid crystals in the joints.

3. Who is affected by gout? Gout is more common in men than in women, especially in middle-aged and older individuals. However, women's risk increases after menopause Genetics : A family history of gout can increase your susceptibility to the gout, and alcohol, can raise uric acid levels and contribute to gout. Obesity: Being overweight or obese increases the risk of gout because excess body weight can lead to higher uric acid levels. Lifestyle Factors : Excessive alcohol consumption and a sedentary lifestyle can contribute to gout risk. Family history of gout. Hypertention(high blood pressure). Kidney disease

4. THE FOUR STAGES OF GOUT Asymptomatic Acute Intercritical Chronic

5. Asymptomatic Hyperuricemia Hyperuricemia occurs when there's too much uric acid in the blood. Uric acid is a normal waste product that is produced when your body breaks down purines. Purines are naturally in your body and they're also in some foods. Consuming lots of purine-rich foods, such as seafood, beer, and drinks high in fructose can increase your chances of getting hyperuricemia . This stage of gout usually has no symptoms.

6. Acute Gout Attack When uric acid levels in the blood become too high, it can seep out and form crystals in the spaces around the joints, causing intense pain and swelling. The pain often comes on suddenly and unexpectedly and can last from a few days to a few weeks. 

7. Intercritical Period Intercritical gout is best described as the stage between attacks, where there are no symptoms, but the buildup of urate crystals is still happening. In this stage, you are still at risk of another attack, and the potential for joint damage is still present. If you've had a gout attack once, you're likely to have one again in the future.

8. Chronic Gout At this point, the crystals in your joints have formed into a substance called tophi, and your affected joints likely have permanent damage at this stage. The tophi may continue to cause redness and swelling in your joints, and treating gout damage at this stage would likely require taking specialized medications.

9. Clinical manifestations Joint pain usually begins over 2-4 hours and during the night May have low grade fever Usually within 2-10 days Joints are normal, with no symptoms between attacks

10. Based on Causes primary Gout - It is not a consequence of acquired disorder Secondary Gout - It is a consequence of specific disorder and specific use of drugs

11. Risk factors Family history Diet Renal disease Obesity Gender-Men are having more risk than women Hypertension Alcohol consumption

12. Other Symptoms The heels, knees, wrists, and fingers, may also be affected The reason for onset at night is due to the lower body temperature Other symptoms may rarely occur along with the joint pain, including fatigue and a high fever

13. Causes Diet. Genetic predisposition (SLC2A9, SLC22A12, and ABCG2) Under excretion of urate (90%) The salts of uric acid Insulin resistance Regular aspirin and niacin use THE MAIN CAUSE IS THE IMBALANCE BETWEEN THE INTAKE AND EXCREATION .  

14. Complications Joint deformity Osteoarthritis Tophi may produce draining sinuses that may become infected Renal stones, pyelonephritis, obstructive renal Disease History & physical examination Clinical symptoms alone are sufficient to make accurate DX in most cases Family history of gout Diagnostic studies

15. Tophi Tophi that form in the small joints of the fingers can cause physical changes and restrict movement. Tophi in the cartilage and bone can eventually lead to joint damage and deformity, and tophi under the skin can be unsightly and become infected and sometimes painful . 

16. Diagnosis Medical history Medication history Family history Clinical presentation Physical examination lab tests (Elevated ESR, WBC) Synovial fluid exam Polarised light microscopy  

17. Treatment of gout If left untreated, gout can eventually lead to gouty arthritis, which is a more severe form of arthritis. This painful condition can leave your joint permanently damaged and swollen. The treatment plan your doctor recommends will depend on the stage and severity of your gout. Medication to treat gout work in one of two ways: They relieve pain and bring down inflammation, or they prevent future gout attacks by lowering uric acid levels

18. Drugs to relieve gout pain include Nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin (Bufferin), ibuprofen (Advil, Motrin), and naproxen (Aleve) colchicine (Colcrys, Mitigare) corticosteroids

19. Drugs that prevent gout attacks include xanthine oxidase inhibitors, such as allopurinol (Lopurin, Zyloprim) and febuxostat (Uloric) probenecid (Probalan) Alongwith medications, your doctor may recommend lifestyle changes to help manage your symptoms and reduce your risk of future gout attacks. For example, your doctor may encourage you to: reduce your alcohol intake, if you drink lose weight, if you’re overweight

20. PREVENTION Here are a few steps you can take to help prevent gout: Limit how much alcohol you drink. Limit how much purine-rich food, such as shellfish, lamb, beef, pork, and organ meat, you eat. Eat a low-fat, non dairy diet that’s rich in vegetables.

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