Gout is a common but complex type of arthritis that can affect anyone. More than 8 million Americans are affected by gout. This condition usually occurs in men over the age of thirty and women past their menopause. It’s believed that estrogen protects women from having gout until the ovaries stop producing the hormone after menopause. Gout causes severe pain, inflammation, and stiffness in the joints. Any joint can be affected but in most cases, gout is found in the big toe. Aside from the big toe, it can also occur in other toes, ankles, knees, elbows, and fingers. Most of the time, only one joint at a time is affected.
Symptoms
- Severe joint pain - The large joint found in the big toe is usually the first to suffer intense pain brought about by gout. The first four to twelve hours are often the most severe.
- Constant discomfort - Lingering joint discomfort that can last from several days up to two weeks.
- Inflammation - Affected joints tend to be swollen.
- Stiffness - Tiny, hard lumps can start accumulating and make the joints stiff.
- Limited mobility - As the condition progresses, you may not be able to move as you normally would.
- Tenderness - Very hot and tender feeling in the affected joint.
- Excessive warmth - Feeling like your joint is on fire.
Causes
Gout is a chronic disease caused by the accumulation of monosodium urate crystals (MSU). This occurs when the body produces too much uric acid or eliminates less of it than it should.
Uric acid is the waste product after the body breaks down purines. These are substances that are naturally found in the body. They can also be found in certain foods such as red meat, liver, sardines, anchovies, scallops, trouts, mussels, tuna, dried beans, green peas, cauliflower, and mushrooms. Some alcoholic beverages like beer and fructose-sweetened drinks also contain purines.
In normal circumstances, uric acid dissolves in the bloodstream which is then converted to urine after going through the kidneys. However, there are instances when you eat too many foods that contain purine, and then too much uric acid is produced, or when the kidneys only discharge little amounts of uric acid. When this happens, uric acid accumulates in joints, tissues, and fluids in the body and form sharp, pointed crystals that cause pain, swelling, and inflammation.
Risk Factors
There are factors that can increase your chance of having elevated levels of uric acid in your body such as the following:
- Diet - Eating a diet high in purines.
- Weight - The body produces more uric acid when you’re overweight. Being obese also makes it hard for the kidneys to eliminate uric acid.
- Age and Gender - Gout is more common in men from 30 to 50. After menopause, men and women have the same risk of developing gout.
- Genetics - If gout runs in your family, you have a high chance of having it.
- Medications - Taking certain medications like diuretics, aspirin, ACE inhibitors, and beta-blockers can increase your uric acid levels.
- Medical conditions - There are conditions and diseases that can increase your chance of having gout. These include hypertension, obesity, diabetes, sleep apnea, metabolic syndrome, kidney disease, and heart disease.
- Alcohol - Consumption of alcohol, especially hard liquor and beer can increase your risk.
- After a trauma or surgery - A gout attack can sometimes be triggered after experiencing a trauma or undergoing surgery.
Gout Stages
Asymptomatic hyperuricemia - This occurs when there the uric acid levels are elevated but there are no signs or symptoms of gout.
Acute gout - This happens when MSU crystals that formed in a joint suddenly induced inflammation and severe pain.
Interval gout - This is the break between acute gout attacks. As gout advances, the intervals between each attack become shorter if the gout is left untreated.
Chronic tophaceous gout - This is the most debilitating stage of gout that could lead to permanent impairment of the joints and the kidneys. At this point, a person can suffer from chronic arthritis and develop stone-like deposits of MSU called tophi.
Pseudogout - Pseudogout symptoms are very much like that of gout but instead of MSU, there is an accumulation of calcium pyrophosphate deposits. The attacks are also less severe.
Complications
Recurring Gout - Some may experience repeated gout attacks within the year. Medications may help in preventing recurrent attacks.
Advance Gout - If left untreated, hard urate crystals may form under the skin. These nodes are called tophi.
Kidney stones - MSU crystals can accumulate in the urinary tract when you have gout. This can cause kidney stones.
Treatment
Gout left untreated will lead to arthritis that can permanently damage your joints. Your doctor will recommend a treatment plan according to your gout’s severity
The American College of Rheumatology recommends allopurinol to all patients with gout. Next is febuxostat. Both medications are classified as xanthine oxidase exhibitors. Non-steroidal anti-inflammatory drugs such as aspirin, ibuprofen, and naproxen are also included. Colchicine and corticosteroids are also recommended.
Aside from medications, you can do several things at home to soothe gout pain. You can apply an icepack to the affected joint several times to help lessen the inflammation. Just like other inflammatory conditions, you can alleviate the pain by resting. Elevating the joint will also bring relief. Keeping yourself hydrated will also help keep the uric acid levels down.
Management
Gout can affect many aspects of your daily life. There are numerous ways you can do to improve your condition and live a normal life such as:
- Avoid foods with high purine content
- Lose weight or maintain a healthy weight
- Be active
- Limit your alcohol intake
- Stay hydrated
- Add fiber to your diet
- Manage stress
- Consult your doctor
Gout is a type of arthritis that can be treated. A little change in lifestyle, some medications, and following the doctor’s orders will help you lead a pain-free healthy happy long life!
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