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Sunday, December 13, 2015

GOUT problems in adult

What Is Gout

·         Historically known as ‘disease of the kings’
·         Gout dates back to 2,600 BC when Egyptians noticed gouty arthritis of the big toe.
·         Hippocrates (400BC) commented on gout.
·         Alfred Baring Garrod (1848) noticed that gout was due to excess uric acid in blood

·         Gout is a medical condition that presents with recurrent attacks of acute inflammatory arthritis.
·         Gout is a medical condition that usually presents with recurrent attacks of acute inflammatory arthritis (red, tender, hot, swollen joint).
·         Gout affects the joints which appear red, swollen, tender and hot.
·         Gout usually affects the big toe first but can affect any joint in the body

·         12% of gout is attributed to dietary causes.
·         Gout is linked with the consumption of food high in purines like alcohol, sugar, meat and seafood
·         Gout presents as a complication of other medical conditions like hypertension and diabetes.
·         Gout may also occur as a result of kidney failure.
·         Gout is caused by a build up of uric acid in the body.
·         Uric acid is a waste product produced by a body’s metabolism.
·         People who kidneys do not excrete uric acid properly, or too much uric acid can have high levels of uric acid in their blood which forms crystals in the joints.
·         Crystals cause the joints to become inflamed and painful.

Who suffers?
·         Gout affects 4 times the amount of men than women. 1% of men in the UK will be affected by gout.
·         Gout usually affects men between the ages of 40 and 60 and women between the ages of 60 and 80.
·         Occurrence of gout is high among African Americans, Pacific Islanders and Maori.

·         A blood test can measure the amount of urate in the blood.
·         Fluid can be removed from the joint with a needle.
·         X ray may rule out other conditions.

·         Avoid food high in purines like red meat, seafood (mackerel and herrings), vegetables (Asaparagus) and food which contain a yeast extract (Marmite/Quorn).
·         Exercise helps decrease levels of uric acid in blood.
·         Allopurinol will help to lower your uric acid levels by disrupting the enzyme that is responsible for converting purines into uric acid.

·         Ice applied for 20-30mins/day decreases pain.
·         NSAIDs reduce the level of pain and inflammation. (Diclofenac+Naproxen)
·         Colchicine helps reduce the level of Uric acid in the blood
·         Corticosteroids can also be used in more severe cases of gout

Gout Complications
·         Frequent and recurring attacks of gout may eventually damage joints permanently.
·         Small white lumps of crystal called Tophi form underneath the skin.
·         10-25% of people with gout have kidney stones which are crystals that collect in the urinary tract causing pain and UTI’s

Physiotherapy and Gout
·         Physiotherapists can help reduce joint stiffness and improve muscle tone through exercise.
·         Acupuncture
·         Laser Therapy
·         Coping Strategies (RICE)

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