Gout as a Complex Form of Arthritis - Essay Example

Gout Gout Introduction Gout is a complex form of arthritis, which is caused by the buildup of uric acid. It most commonly occurs at the joint at the base of the big toe, though this is more often known as podagra, a more specific form of the gout disease. Symptoms can come on suddenly and be extremely painful. Fortunately, there are several medications and home remedies to treat this disease. Physiology Gout is a health disorder that involves purine metabolism. In its final state as uric acid, the acid crystallizes in the form of monosodium urate and becomes attached to joints, tendons, and tissue in the surrounding area (Terkeltaub, 2010). The acid crystals then prompts an immune-mediated inflammatory reaction, “with one of the key proteins in the inflammatory cascade being interleukin 1β (Bardin, 2010).” It has been discovered that there has been an immense loss of uricase in humans, which is what breaks down the uric acid in humans. This has been thought to be the major reason as to why gout has become so common. Causes The primary cause of gout is when urate crystals in the body begin collecting around the joints, which then produces inflammation and the extreme pain of a gout attack. “Urate crystals can form when you have high levels of uric acid in your blood (Mayo Clinic, 2009.)” Uric acid is created in the body when purines or certain foods, such as herring and mushrooms, are broken down. When the uric acid fails to dissolve in the blood, the acid builds up, creating the needle-like crystals that begin to surround the joint. Other causes of gout include a person’s diet, especially when it involves too much alcohol, seafood, or fructose. These are among some of the foods that can cause a build up of uric acid. Pre-existing medical conditions or the medication used to treat other conditions can also cause gout, if not put an individual at greater risk for developing gout. Genetics can also be a cause for gout, mainly when issues with the kidney are present. Indeed, gout is mainly a genetic disease; people can increase their risk at developing the gout disorder if they have any sort of rare genetic disorder, such as familial juvenile hyperuricernic nephropathy (Meldon, 2010). Symptoms The symptoms of gout are always intense and incredibly painful, and they occur more commonly at night. There is never warning when a person is going to feel the pain of gout. Though the intense joint pain is most common in the joint of the big toe, it can also be present in the feet, ankles, knees, and wrists - the major joints of the body. The intense pain is acute during the first twelve to twenty-four hours after the pain initially begins. Even after the intense pain abates, there is still discomfort in the joint that could last anywhere from a couple of days to a few weeks. The attacks that come after the initial attack of pain last longer and can have an effect on more joints. The surface of the joint that is affected becomes swollen and red. When the gout reaches this stage, it is important for the individual to seek treatment as that affected area could be infected. If treatment is not sought immediately, not only will the symptoms get worse and the pain increase, but the person can risk permanently damaging their joints. Methods of diagnosis Diagnosing an individual with gout involves blood tests that can measure the uric acid level in the blood. However, the blood tests can be inaccurate since some people naturally have high levels or uric acid but never develop gout; likewise, some people can have gout, but have normal levels of uric acid in the blood. Therefore, along with the blood tests, joint fluid tests are undergone, which involves drawing fluid from the joint that is affected. The sample is placed under a microscope to see if urate crystals can be detected. Between these two tests, other diseases can be thrown out to allow for a perfect diagnosis. Treatment and prevention Various medications exist to help treat gout and to alleviate the pain associated with gout, as well as to reduce complications that are connected with gout, including complications that can arise due to the deposits of urate crystals. There are also medications that help to control the amount of uric acid in a person. The medications used to treat current gout and to prevent future attacks consist of nonsteroidal anti-inflammatory drugs (NSAIDs), which maintain the inflammation and pain that is consistent with gout (Emmerson, 2003). Higher doses can be given for acute attacks and lesser doses can be given afterwards to prevent attacks later on. These types of medication can either come as a prescription or be purchased over the counter, such as Advil or Aleve. Colchicine is similar to the NSAIDs except they are more effective if taken immediately after the onset of symptoms. There are also medications that tend to uric acid production. Xanthine oxidase inhibitors can block uric acid production by limiting the amount of the acid that the body makes. However, these medications can cause new attacks if taken immediately after a previous attack has ceased. Probenecid is prescribed to improve uric acid removal by enhancing the function of the kidney to remove the uric acid from the body. Some of the aforementioned medications can be also used to prevent the onset of an intense gout attack. The medications are usually prescribed when a person is first begins complaining about intense pain in one of their joints. At this time, or beforehand to people that are at risk for gout, doctors suggest to their patients to change their diets in an attempt to avoid some of the foods that can cause gout. Often, gout is unpreventable until the person first starts experiencing pain. Conclusion Gout is a form of arthritis that is caused by a buildup of uric acid, which crystallizes and attaches itself to joints, tendons, and tissues. Gout is caused when the kidney does not get rid of enough of the acid; it can also be caused due to genetics or a person’s diet. There are many medications designed to help control the intensity of the attacks, as well as to prevent future attacks from occurring. These same medications can also help prevent gout before the onset of a major attack. To diagnose gout, doctors take blood and joint fluid sample to see if the acid has begun to crystallize. References Bardin, T. (2010). Gout. Lancet, 375(9711), 318-328. Emmerson, B. T. (2003). Getting rid of gout (2nd ed.). South Melbourne, Australia: Oxford University Press. Mayo Clinic. (2009, November 14). Gout: Causes. Mayo Clinic. Retrieved March 16, 2011, from http://www.mayoclinic.com/health/gout/DS00090/DSECTION=causes Meldon, A. (2010). A treatise on gout. London: Read Books Design. Terkeltaub, R. (2010). Update on gout: New therapeutic strategies and options. Nat Rev Rheumatol, 6(1), 30-38. Read More