Uric acid is a by-product of the breakdown of the nucleic acids ribonucleic acid [ RNA Transcription and translation Genes are segments of deoxyribonucleic acid DNA that contain the code for a specific protein that functions in one or more types of cells in the body. Chromosomes are structures within cells It is present in small amounts in the blood, because the body continually breaks down cells and forms new cells.
Also, the body readily transforms substances in foods called purines into uric acid. Uric acid is removed from the blood mainly through the kidneys and through the gastrointestinal system. Most often, the uric acid level in the blood becomes abnormally high when the kidneys cannot eliminate enough uric acid in the urine. This cause is usually determined by the person's genes. Too much uric acid in the blood can result in uric acid crystals being formed and deposited in and around joints.
However, a strict low-purine diet lowers the uric acid level by only a small amount. Combining a high-purine diet with alcohol or especially beverages containing high-fructose corn syrup can worsen matters because all of these beverages can increase the production of uric acid and interfere with its elimination by the kidneys.
For unknown reasons, not all people who have an abnormally high level of uric acid in the blood hyperuricemia develop gout. Thus, gout should not be diagnosed by blood test alone. Certain cancers and blood disorders such as lymphoma Overview of Lymphoma Lymphomas are cancers of lymphocytes, which reside in the lymphatic system and in blood-forming organs. Lymphomas are cancers of a specific type of white blood cells known as lymphocytes.
White blood cells develop from stem cells in the bone marrow. Sometimes the development goes awry Certain drugs such as thiazide diuretics, cyclosporine , pyrazinamide , ethambutol , and nicotinic acid. Lead poisoning Lead Poisoning Some causes of lead poisoning are ingesting lead paint and eating or drinking from certain imported, improperly lead-glazed ceramics. Very high levels of lead in the blood may cause personality Obesity Obesity Obesity is excess body weight.
Obesity is influenced by a combination of factors, which usually results in consuming more calories than the body needs. These factors may include physical inactivity Psoriasis Psoriasis Psoriasis is a chronic, recurring disease that causes one or more raised, red patches that have silvery scales and a distinct border between the patch and normal skin.
A problem with the immune Radiation therapy Radiation Therapy for Cancer Radiation is a form of intense energy generated by a radioactive substance, such as cobalt, or by specialized equipment, such as an atomic particle linear accelerator. Radiation preferentially Cancer chemotherapy Chemotherapy Chemotherapy involves the use of drugs to destroy cancer cells.
Although an ideal drug would destroy cancer cells without harming normal cells, most drugs are not that selective. Instead, drugs Major causes are diabetes and high blood pressure High levels of uric acid in the blood often lead to high levels of uric acid in the joints.
This process may then result in the formation of uric acid crystals in the joint tissue and the fluid within the joints synovial fluid. Gout most often affects the joints in the feet, particularly at the base of the big toe swelling, pain, and redness of the big toe is called podagra.
However, it also commonly affects other areas: the ankle, instep, knee, wrist, and elbow. Gout tends to affect these cooler areas because uric acid crystals form more readily in cool than in warm areas. Rarely, gout affects the joints of the warmer, central part of the body, such as the spine, hips, or shoulders. Sudden severe flare-ups attacks of gout called acute gouty arthritis can occur without warning.
They may be triggered by. Illness such as pneumonia Overview of Pneumonia Pneumonia is an infection of the small air sacs of the lungs alveoli and the tissues around them. Pneumonia is one of the most common causes of death worldwide. Often, pneumonia is the final Start of treatment with certain drugs such as diuretics, allopurinol , febuxostat , probenecid , and nitroglycerin , particularly nitroglycerin given by vein, which contains alcohol that may suddenly change the uric acid level in the blood but often those drugs are medically necessary.
Typically during a flare, severe pain occurs suddenly in one or more joints, often at night. The nighttime pain occurs probably because fluid that has built up in the joint during the daytime leaves the joint faster than uric acid does when a person lies down, making the uric acid more concentrated and thus more ready to form crystals.
The pain becomes progressively worse and is often excruciating, particularly when the joint is moved or touched. The joint becomes inflamed—it swells and feels warm, and the skin over the joint may appear red or purplish, tight, and shiny.
The symptoms gradually disappear, joint function returns, and no symptoms appear until the next flare-up. However, if the disorder progresses, untreated flare-ups last longer, occur more frequently, and affect several joints.
If left untreated, later flare-ups can last up to 3 weeks. Over time, joint motion becomes progressively restricted by damage caused by deposits of uric acid crystals in the joints and tendons. Hard lumps of uric acid crystals tophi are first deposited in the joint synovial lining or cartilage or in bone near the joints and then under the skin around joints.
Tophi can also develop in the kidney and other organs and under the skin on the ears. They commonly develop in the fingers, hands, feet, the tough band extending from the calf muscles to the heel Achilles tendon , or around the elbows.
If untreated, tophi in and around the joints can burst and discharge chalky masses of uric acid crystals through the skin and may eventually cause deformities and osteoarthritis Osteoarthritis OA Osteoarthritis is a chronic disorder that causes damage to the cartilage and surrounding tissues and is characterized by pain, stiffness, and loss of function.
Arthritis due to damage of joint People who have gout may develop kidney stones urolithiasis Stones in the Urinary Tract Stones calculi are hard masses that form in the urinary tract and may cause pain, bleeding, or an infection or block of the flow of urine. Tiny stones may cause no symptoms, but larger stones The stones may block the urinary tract, resulting in excruciating pain and, if untreated, infection and kidney damage. In people with gout who also have another disorder that damages the kidneys such as diabetes Diabetes Mellitus DM Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar glucose levels to be abnormally high.
Urination and thirst are Often no cause for high blood pressure can be identified, but sometimes it occurs as a result of an underlying Gout with joint damage increases the risk of developing osteoarthritis Osteoarthritis OA Osteoarthritis is a chronic disorder that causes damage to the cartilage and surrounding tissues and is characterized by pain, stiffness, and loss of function.
Doctors suspect gout on the basis of its distinctive symptoms and an examination of the affected joints. J Korean Rheum Assoc. Hip pain as the presenting manifestation of acute gouty sacroiliitis. J Clin Rheumatol. Gout in the axial skeleton. J Rheumatol. Epub Feb 4. Eur Radiol. DOI: Crystal Arthritis. In: Efthimiou P, ed. Absolute Rheumatology Review. Springer Nature Switzerland AG; ; chap Accessed September 15, Clin Rheumatol. Uric acid excretion in the relatives of patients with gout.
Ann Rheum Dis. Nocturnal risk of gout attacks. Arthritis Rheumatol. Relation of temperature and humidity to the risk of recurrent gout attacks. Am J Epidemiol. Roddy E. If a person produces too much uric acid or does not excrete enough, it can build up and form needle-like crystals.
These trigger inflammation and pain in the joints and surrounding tissue. The main symptom of gout is intense joint pain that subsides to discomfort, inflammation, and redness.
The condition frequently affects the base of the big toe but can also occur in the forefoot, ankles, knees, elbows, wrists, and fingers. In some cases, gout can develop into more severe conditions , including kidney stones or recurrent gout. There are many lifestyle and dietary guidelines a person can try to protect against flares or prevent gout from occurring in the first instance:.
Individuals with gout can manage flare-ups by moderating what they eat and drink — a balanced diet can help reduce symptoms. Decreasing foods and drinks high in purines to ensure that uric acid levels in the blood do not get too high is an important first step. A person can reduce their risk of developing gout by limiting their intake of purine-rich foods.
However, avoiding purine consumption altogether is not necessary. Moderate consumption of purine-rich items can help manage uric acid levels and gout symptoms and benefit overall dietary health. Gout is a type of inflammatory arthritis. As a result, a person experiencing symptoms of gout may benefit from general arthritis home treatments. These include staying active, maintaining a moderate weight, and performing low-impact exercises to supportjoint health.
Gout is a common form of arthritis that affects the joints. It can lead to intense pain, swelling, and stiffness. The condition affects more than 3 million Americans and is more prevalent in males than females.
Individuals may experience hyperuricemia if their body overproduces uric acid or if their kidneys do not excrete the substance adequately. A doctor will typically recommend prescription medications to treat gout. This may include treatments to reduce inflammation in the affected joints and drugs to help regulate uric acid levels.
People can help reduce their risk of developing gout by avoiding foods high in purines that the body converts into uric acid, keeping adequately hydrated, and avoiding alcohol. What is gout and how might diet affect symptoms? Learn about foods to avoid and those that can help manage gout.
Also, get some tips on weight…. People use their feet almost constantly, whatever level of activity they are involved in on a daily basis. Osteoarthritis causes the cartilage that protects the joints to wear away, leading to pain and stiffness. Find out more about what happens, who is at….
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