HyperUricemia (Gout), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Hyperuricemia (Gout) is a medical disorder caused by the excessive uric acid in the blood.
Gouty arthritis is an arthritis which resulted from deposits of needle like crystals in the joint spaces.
The prickling effect of these needles induces sudden episodes of pain, tenderness, redness, warmth and swelling of the joints.
It is the most common form of arthritis in men over the age of 40.
Women are normally protected from gout until after menopause.
Uric acid is normally harmless and is produced in the body.
Most uric acid is passed out with the urine and some from the intestines with the feces (stools).
In people with gout the amount of uric acid in the blood goes up.
From time to time the level may become too high and tiny grit-like crystals of uric acid may form.
The crystals prick the tissues in the joint to cause inflammation, swelling and pain - a gout attack.
Acute gout is a painful condition that often affects only one joint.
Chronic gout is the repeated episodes of inflammation and pain.
More than one joint may be involved
Deposits can also form in the kidney and urinary tract as urate stones or crystals.
Urate crystals (tophi) are also deposited in the skin, mostly frequently at the joints and earlobe.
Gout is usually diagnosed if the patient has the typical gout symptoms and a raised blood level of uric acid.
Not everyone with high uric acid levels in the blood has gout.
Blood uric acid is raised above 7 mg/dL (high).
Typical features of gouty arthritis with warm red swollen and painful joint especially in locations such the big toe, ankle or knee
a. Synovial fluid analysis (shows uric acid crystals)
If there is doubt as to the source of the pain and swelling, the doctor may aspirate some fluid out of a swollen joint.
Crystals of uric acid (urate) can be seen in the fluid to confirm the diagnosis of gout.
Treatment of the acute gouty arthritis is:
1. Rest the joint
2. Drinks lots of water (e.g. 3 glasses of water) immediately during an acute attack.
3. If the patient is able to, raise the affected limb (normally a leg) to help decrease the swelling.
The easiest way to raise the leg is to recline on a sofa with the leg up on a cushion.
If the big toe is affected, raise it above the heart level to help the blood flow.
4. An ice pack placed against the inflamed joint may reduce the pain until the gout treatment medicines (below) start to act:
The guidelines advise colchicines and NSAIDs as the first-line option for acute gout.
NSAIDs are the first-line treatment
Colchicine helps reduce pain, swelling, and inflammation.
Probenecid lowers the uric acid through gradual excretion of uric acid in the urine.
Canakinumab is a recombinant monoclonal antibody active as a restrictor of pro-inflammatory cytokine IL-1 if colchicines and NSAIDs do not work.
Steroid tablets or injections can also decrease the inflammation and pain.
The central role recently identified for pro-inflammatory cytokine IL-1 has led to the production of inhibitors such as anakinra, canakinumab and rilonacept.
It is very important to drink at least 8 glasses of water daily to help flush out the uric acid.
Prevention can be with the use of Allopurinolol, probenecid and Febuxostat.

TABLE OF CONTENT
Introduction
Chapter 1 Hyper Uricemia
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Osteoarthritis
Chapter 8 Rheumatoid Arthritis
Epilogue

• Language: English
• Publisher: Kenneth Kee
• Release date: Nov 9, 2016
• ISBN: 9781370201358

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

HyperUricemia

(Gout),

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2016 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes the Hyperuricemia (Gout), Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What You Need to Treat Hyperuricemia)

This eBook is licensed for the personal enjoyment only. This eBook may not be re-sold or given away to other people. If you would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank you for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Condition) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Conditions into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 700 amazon kindle books and some into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical conditions.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring you the latest information about a condition or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the books more easily.

I apologize if these repetitions are irritating to some readers.

Chapter 1

Gout

I had a patient who would limp into my clinic every time after a night out drinking alcohol.

I would give him an injection into the most painful joint and a uricosuric drug (to pass out the uric acid from the body through the urine) and pain killer.

After the injection he was able to walk out of the clinic without limping

He would be well until the next episode of gouty arthritis.

Some other patient a Malay middle aged gentleman will have the same problem after taking peanuts while watching football matches on television.

Recently I have a woman patient whose family has gout who had an acute attack of gout which occurs after the removal of her womb and ovaries for enlarged fibroid.

She had never believed the brother’s story of how painful the big toe can become until she experienced it herself.

She just has taken her usual amount of soya bean curds and other soya bean foods which have never given her problem before.

Probably her female hormones may have protected her earlier from the gout.

The second time she had the gout attack was in her knee which became larger than usual.

I had to give her an injection of steroid in her knee before it finally recovered.

Another young patient, who is vegetarian, has a severe episode of diarrhea and vomiting also developed severe pain in his right big toe

It was due to the dehydration which caused the uric acid to go up.

In addition he was also taking high protein bars.

He improved after taking medicines and drinking lots of water.

He did not have another attack.

Prevention was to drink lots of water to dilute the uric acid in the blood and take a drug called allopurinol which help to turn the uric acid to urea.

What is Hyperuricemia (Gout)?

Hyperuricemia (Gout) is a medical disorder caused by the excessive uric acid in the blood.

Gouty arthritis is an arthritis which resulted from deposits of needle like crystals in the joint spaces.

The prickling effect of these needles induces sudden episodes of pain, tenderness, redness, warmth and swelling of the joints.

It is the most common form of arthritis in men over the age of 40.

Women are normally protected from gout until after menopause.

Uric acid is normally harmless and is produced in the body.

Most uric acid is passed out with the urine and some from the intestines with the feces (stools).

In people with gout the amount of uric acid in the blood goes up.

From time to time the level may become too high and tiny grit-like crystals of uric acid may form.

The crystals normally collect in a joint.

The crystals prick the tissues in the joint to cause inflammation, swelling and pain - a gout attack.

Acute gout is