Puricil Gout Treatment by Selmedica Healthcare| Gout Overview

reat Gout

Naturally

With Puricil

"What is Gout?"

Gout is one of the most painful rheumatic diseases. It results from deposits

of needle-

like crystals of uric acid in connective tissue, in the joint space

between two bones, or in

both. These deposits lead to inflammatory arthritis,

which causes swelling, redness,

heat, pain, and stiffness in the joints. The term

arthritis refers to more than 100 different

rheumatic diseases that affect the joints,

muscles, and bones, as well as other tissues

and structures. Gout accounts for

approximately 5 percent of all cases of arthritis.

Pseudogout is sometimes confused with gout because it produces similar

symptoms of

inflammation. However, in this condition, also called chondrocalcinosis,

deposits are

made up of calcium phosphate crystals, not uric acid. Therefore,

pseudogout is treated

somewhat differently and is not reviewed in this

ext

Uric acid is a substance that results from the breakdown of purines, which are

part of all

human tissue and are found in many foods. Normally, uric acid is

dissolved in the blood

and passed through the kidneys into the urine, where

it is eliminated. If the body

increases its production of uric acid or if the kidneys

do not eliminate enough uric acid

from the body, levels of it build up in the blood

(a condition called hyperuricemia).

Hyperuricemia also may result when a person

eats too many high-purine foods, such as

liver, dried beans and peas, anchovies,

and gravies. Hyperuricemia is not a disease and

by itself is not dangerous. However,

if excess uric acid crystals form as a result of

hyperuricemia, gout can develop. The

excess crystals build up in the joint spaces,

causing inflammation. Deposits of uric

acid, called tophi (singular: tophus), can appear

as lumps under the skin around the

joints and at the rim of the ear. In addition, uric acid

crystals can collect in the kidneys

and cause kidney stones.

For many people, gout initially affects the joints in the big toe. Sometime during the

course of the disease, gout will affect the big toe in about 75 percent of patients. It

also

can affect the instep, ankles, heels, knees, wrists, fingers, and elbows.

The

disease can

progress through four stages:

Asymptomatic (without symptoms) hyperuricemia--In this stage, a person

has elevated

levels of uric acid in the blood but no other symptoms. A person

this stage does not

usually require treatment.

Acute gout, or acute gouty arthritis--In this stage, hyperuricemia has

caused

the deposit

of uric acid crystals in joint spaces. This leads to a sudden

onset

of intense pain and

swelling in the joints, which also may be warm and

very tender. An acute attack

commonly occurs at night and can be triggered

by stressful events, alcohol or drugs, or

the presence of another illness. Early

attacks usually subside within 3 to 10 days, even

without treatment, and the

next attack may not occur for months or even years. Over

time, however,

attacks can last longer and occur more frequently.

Interval or intercritical gout--This is the period between acute attacks.

In this stage, a

person does not have any symptoms and has normal

joint function.

Chronic tophaceous gout--This is the most disabling stage of gout and

usually develops

over a long period, such as 10 years. In this stage, the

disease has caused permanent

damage to the affected joints and sometimes

to the kidneys. With proper treatment,

most people with gout do not progress

to this advanced stage.

hat Causes Gout?

A number of risk factors are related to the development of hyperuricemia and gout:

Genetics may play a role in determining a person's risk, since up to 18

percent of people

with gout have a family history of the disease.

Gender and age are related to the risk of developing gout; it is more

common in men

than in women and more common in adults than in children.

Being overweight increases the risk of developing hyperuricemia and gout
because there is more tissue available for turnover or breakdown, which

leads to excess uric acid

production.

Drinking too much alcohol can lead to hyperuricemia because it interferes

with the

removal of uric acid from the body.

Eating too many foods rich in purines can cause or aggravate gout in

some people.

An enzyme defect that interferes with the way the body breaks down purines
causes gout in a small number of people, many of whom have a family history

of gout.

Exposure to lead in the environment can cause gout.

Some people who take certain medicines or have certain conditions are at risk for

having high levels of uric acid in their body fluids. For example, the following types

medicines can lead to hyperuricemia because they reduce the body's ability to

remove

uric acid:

Diuretics, which are taken to eliminate excess fluid from the body in

conditions like

hypertension, edema, and heart disease, and which

decrease the amount of uric acid

passed in the urine;

Salicylates, or anti-inflammatory medicines made from salicylic acid, such as
aspirin;

The vitamin niacin, also called nicotinic acid;

Cyclosporine, a medicine used to suppress the body's immune system (the
system that protects the body from infection and disease) and control the

body's rejection of

transplanted organs; and

Levodopa, a medicine used to support communication along nerve

pathways in the

treatment of Parkinson's disease.

Who Is Likely To Develop Gout?

Gout occurs in approximately 840 out of every 100,000 people. It is rare in

children and

young adults. Adult men, particularly those between the ages of

40 and 50, are more

likely to develop gout than women, who rarely develop

the disorder before menopause.

People who have had an organ transplant

are more susceptible to gout.

ow Is

Gout

Diagnosed

Gout may be difficult for doctors to diagnose because the symptoms may be

vague, and

they often mimic other conditions. Although most people with gout

have hyperuricemia at

some time during the course of their disease, it may not

be present during an acute

attack. In addition, having hyperuricemia alone does

not mean that a person will get

gout. In fact, most people with hyperuricemia do

not develop the disease.

To confirm a diagnosis of gout, a doctor may insert a needle into an inflamed

joint

and

draw a sample of synovial fluid, the substance that lubricates a joint.

A laboratory

technician places some of the fluid on a slide and looks for

monosodium urate crystals

under a microscope. Their absence, however,

does not completely rule out the

diagnosis. The doctor also may find it helpful

to examine chalky, sodium urate deposits

(tophi) around joints to diagnose gout.

Gout attacks may mimic joint infections, and a

doctor who suspects a joint infection

(rather than gout) may check for the presence of

bacteria.

Signs and Symptoms of Gout

Hyperuricemia

Presence of uric acid crystals in joint fluid

More than one attack of acute arthritis

Arthritis that develops in 1 day, producing a swollen, red, and warm joint

Attack of arthritis in only one joint, usually the toe, ankle, or knee

How Is Gout

Conventionally

Treated?

With proper treatment, most people with gout are able to control their symptoms

and live

productive lives. Gout can be treated with one or a combination of therapies.

The goals

of treatment are to ease the pain associated with acute attacks, to prevent

future

attacks, and to avoid the formation of tophi and kidney stones. Successful

treatment can

reduce both the discomfort caused by the symptoms of gout and long-

term damage of

the affected joints. Treatment will help to prevent disability due

to gout.

The most common treatments for an acute attack of gout are high doses of

nonsteroidal

anti-inflammatory drugs (NSAIDs) taken orally (by mouth) or

corticosteroids, which are

taken orally or injected into the affected joint. NSAIDs

reduce the inflammation caused

by deposits of uric acid crystals but have no effect

on the amount of uric acid in the

body. The NSAIDs most commonly prescribed for

gout are indomethacin (Indocin*) and

naproxen (Anaprox, Naprosyn), which are taken

orally every day. Corticosteroids are

strong anti-inflammatory hormones. The most

commonly prescribed corticosteroid is

prednisone. Patients often begin to improve

within a few hours of treatment with a

corticosteroid, and the attack usually goes

away completely within a week or so.

* Brand names included in this

ext

are provided as examples only, and their

inclusion

does not mean that these products are endorsed by

HFB or T

he National Institutes of

Health. Also, if a particular brand name is not

mentioned, this does not mean or imply

that the product is unsatisfactory.

When NSAIDs or corticosteroids do not control symptoms, the doctor may

consider using

colchicine. This drug is most effective when taken within the

first 12 hours of an acute

attack. Doctors may ask patients to take oral

colchicine as often as every hour until joint

symptoms begin to improve or

side effects such as nausea, vomiting, abdominal cramps,

or diarrhea make

it uncomfortable to continue the drug.

For some patients, the doctor may prescribe either NSAIDs or oral colchicine

in small

daily doses to prevent future attacks. The doctor also may consider

prescribing

medicine such as allopurinol (Zyloprim) or probenecid (Benemid)

to treat hyperuricemia

and reduce the frequency of sudden attacks and the

development of tophi.

What Can People With Gout Do To Stay Healthy?

To help prevent future attacks, take the medicines your doctor prescribes.
Carefully follow instructions about how much medicine to take and when

to take it. Acute gout

best treated when symptoms first occur.

Tell your doctor about all the medicines and vitamins you take. He or she

can tell

you if

any of them increase your risk of hyperuricemia.

Plan followup visits with your doctor to evaluate your progress.

Maintain a healthy, balanced diet; avoid foods that are high in purines;

and drink plenty

of fluids, especially water. Fluids help remove uric acid

from the body.

Exercise regularly and maintain a healthy body weight. Lose weight if

you are

overweight, but do not go on diets designed for quick or extreme

loss of weight because

they increase uric acid levels in the blood.

ere

Can

Find More Information About Gout

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

National Institutes of Health

1 AMS Circle

Bethesda, MD 20892-3675

Phone: 301-495-4484 or 877-22-NIAMS (226-4267) (free of charge)

TTY: 301-565-2966

Fax: 301-718-6366

E-mail: NIAMSInfo@mail.nih.gov

www.niams.nih.gov

NIAMS provides information about various forms of arthritis and rheumatic diseases

and bone, muscle, joint, and skin diseases. It distributes patient and professional

education materials and also refers people to other sources of information.

Additional information and updates can be found on the NIAMS Web site.

American College of Rheumatology/Association of Rheumatology Health Professionals

1800 Century Place, Suite 250

Atlanta, GA 30345-4300

Phone: 404-633-3777

Fax: 404-633-1870

www.rheumatology.org

This association provides referrals to rheumatologists. The organization also provides

educational materials and guidelines about many different rheumatic diseases.

Arthritis Foundation

P.O. Box 7669

Atlanta, GA 30357-0669

Phone: 404-872-7100 or 800-568-4045 (free of charge)

or your local chapter (listed in the telephone directory)

www.arthritis.org

This is the main voluntary organization devoted to arthritis. The foundation publishes

free pamphlets on many types of arthritis and a monthly magazine for members that

provides up-to-date information on arthritis.

"You Have Nothing To Lose With

Selmedica Healthcares

365 Day

100% Money Back Guarantee"