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Gout

Gout, a condition caused by a buildup of uric acid (hyperuricemia) and its accumulation in the form of microcrystals in joints, kidneys, soft tissues and other areas of the body.

Generally, hyperuricemia in gout is caused by the accumulation of uric acid in the blood. Uric acid comes from two places -- produced by the body and from the diet. Any extra uric acid usually filters through the kidneys and gets passed in urine. If the body produces too much uric acid or fails to excrete it in the urine, microcrystals form causing inflammation. The most common factor that increases the chance of hyperuricemia and gout attacks is excess consumption of alcohol, especially beer. Beer increases the amount of uric acid produced and, in turn, reduces its elimination through the urine. Meals that are rich in purines – liver, kidneys – can cause its development.

Symptoms

Essentially, gout is a form of arthritis (joint inflammation); it almost always occurs in a severe form and in a sole joint, becoming intensely inflamed in a few hours. When it becomes inflamed, the joint wells and reddens, and almost always, is extremely painful. Mobility can have repercussions from the pain. Other times, inflammation may be less intense and the disability less bothersome.

Gout attacks can affect diverse joints but the most common is in the big toe (called are called podagra attacks), instep, ankle, knee, wrist or finger joints.

Prevention

The persistence of high levels of uric acid (above 7mg/dl uric acid in the blood) in those patients with gout will cause more attacks to happen and consequently will affect more joints. On the other hand, if the levels of uric acid are reduced by treatment to normal levels, the crystals will slowly dissolve until they disappear, and thus, the possibility of having new attacks of gout is reduced. Gout attacks are usually quite painful and require medication.

When the gout attack ceases, the uric acid crystals stay in the joint and could cause another attack. Helping the crystals to dissolve and lowering the uric acid levels in the blood with medicines is very effective in the prevention of new attacks.

Controlling obesity and following a good diet help to maintain the adequate uric acid levels, as well as:

  • Avoiding prolonged fasting
  • Avoiding alcohol, especially beer and liquor
  • Drinking at least 2 liters of water daily

 

Reducing the amount of purine-rich foods: broths made from fatty meats and meat extracts, meat visceras (kidney, liver, gizzard, brain, etc.), anchovies, grains, gravies, kidneys, liver, sardines, sweetbreads, asparagus, bacon, beef, bluefish, bouillon, calf tongue, carp, cauliflower, chicken, chicken soup, codfish, crab, duck, goose, halibut, ham, honey, kidney beans, lamb, lentils, lima beans, lobster, mushrooms, mutton, navy beans, oatmeal, oysters, peas, perch, pork, rabbit, salmon, sheep, shellfish, snapper, spinach, refined sugars, tripe, trout, tuna, turkey, veal, venison

Gene or region studied

  • SLC17A3
  • ABCG2
  • SLC2A9
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