What is Gout? In short, Gout is an arthritic disease of your joints caused due to high uric levels in your body that most commonly affects the big toe.
2. What Causes Gout?
Pathophysiology Of Gout
Normally, your liver processes various substances in your body including purines. These are genetic materials which are found in the inside of your cells and in some foods you eat.
In general, when the liver breaks on purines, it produces a waste product called uric acid. Kidneys dispose of this waste product which is present in your bloodstream.
- Firstly, when your liver produces too much of uric acid or
- Secondly, when your kidneys don’t remove enough of uric acid from your body.
What Causes Gout?
To demonstrate, excess uric acid levels will be accumulated in your blood. This condition is hyperuricemia. Therefore, the concentration of uric acid levels becomes too high and it cannot dissolve.
The increased uric acid level begin to form needle-like crystals inside the joint most commonly in the big toe. Formation of uric acid crystals results in an inflammatory response. The white blood cells begin to attack the accumulation of urate crystals. Thus, it results in joint pain and inflammation. This is called an acute gout attack.
3. What Happens If It Is Left Untreated?
In some cases, this elevated uric acid levels can result in lumpy deposits called tophi around your joint called advanced gout. This causes additional joint pain and disfigurement which have chances to permanently damage your joints.
4. Symptoms And Signs Of Gout
Severe Joint Pain
In fact, it most commonly affects the big toe. It can also occur in other joints like ankles, elbows, fingers, wrist and knees. In some people, it is so severe that they couldn’t even handle the bedsheet touching their feet.
Redness And Inflammation
The affected joint becomes swollen, warm, tender and red. At this time, pain mostly occurs within the first 4 – 12 hours and inflammation lasts from 3 -10 days.
Therefore, you may not be able to move your joints normally.
In some cases, people may also feel asymptomatic.
5. Risk Factors Of Gout
Who Are Mostly Affected By Gout?
Gout occurs mostly in man because women tend to have low uric acid levels primarily. In some cases, it also occurs in women due to the reach of high uric acid levels after menopause.
It mostly occurs between the ages of 30 to 75. Women develop signs and symptoms after menopause.
If you are overweight, your body has chances to produce high uric acid levels and your kidneys feel difficult to dispose it.
In addition to this, the previous history of high blood pressure, diabetes, heart and kidney disease have more chances to develop gout.
If other members of your family have a previous history of gout, you are more likely to develop it.
Recent Trauma Or Surgery
If you have experienced trauma and surgery, it is associated with an increased risk of gout.
6. What Foods To Eat To Reduce Uric Acid Levels?
- Low-fat dairy products such as yoghurt
- Plant oils such as olive oil
- Pulses like chickpeas and kidney beans
- Peas, beans and lentils
- Vegetables including mushrooms
- High fibre fruits – pear, guava, Apple. ( the apple peels contains more fibre), bananas
- Low sugar fruits- honeydew melon, orange, grapes, blackberries, lemons
- Whole grains
7. Treatment Of Gout
Seek medical care immediately when you experience sudden intense pain in your joints. If left untreated, it can worsen the condition.
You will be treated with
- Nonsteroidal anti-inflammatory drugs- which is used to reduce inflammation. Your doctor will provide you with a higher dose to treat acute attack and a lower to prevent future attacks.
- Corticosteroids-Corticosteroids are used to treat pain and inflammation. In fact, they are administered through oral or intraarticular(through an injection into your joint.)
- Medications That Block Uric Acid Production- Drugs called Xanthine oxidase inhibitors including allopurinol limit the amount of uric acid your body makes. This may lower the blood’s uric acid level and reduce the risk of gout.
- Medications That Improve Uric Acid Removal- The drug uricosurics improve your kidney’s ability to remove uric acid from your body to remove it in the form of urine. This may lower your uric acid levels from the blood and reduce the risk of gout.
Most importantly, medications should not be taken without your doctor’s advice due to the unawareness of previous underlying conditions in your body.
8. Does Gout Medications Contain Side Effects?
In some cases, out medications are well tolerated, however they contain some side effects like any other medications.
- Allopurinol is used to inhibit uric acid production and it can cause an allergic rash in some people.
- Colchicine used to treat pain can cause nausea, diarrhoea and rarely a muscle weakness.
- Febuxostat can cause liver abnormalities, nausea and rash.
- Nonsteroidal anti-inflammatory agents can cause stomach irritation and ulcer in some people. In particular, liver and kidney tests are always periodically monitored for patients who are taking NSAIDs for the long term.
9. What Are The Other Ways You Can Do To Support The Treatment Of Gout?
1. Drink water!
Firstly, the most effective ways to reduce inflammation is to drink water. Increasing the fluid consumption can kickstart a person’s kidney to release excess fluid which can reduce swelling.
You should avoid alcohol definitely which are very high in purines.
Note: Most importantly, if you have a previous history of congestive heart failure or kidney condition, you should talk about this to your doctor before excessive fluid intake.
2. Apply Ice To The Affected Joints
Applying a cloth related ice pack of 5- 15 minutes to the joint reduce gout inflammation.
3. Elevating The Affected Joints
On the whole, gout can cause pain and swell especially in the ankles, knees, feet and hands.
Elevating the joints can help to reduce the swelling which encourages the blood and fluid to move away from the joint and back towards the heart.
4. What About Fish Intake
A 2016 study mentioned that tuna extract helps to reduce the levels of uric acid levels in the blood.
However, some nutrition websites mention that tuna extract may worsen the symptoms.
5. Reduce The Stress
In fact, more stress can lead to increased anxiety and worsen the health condition.
- Try to do exercise – a walk if the activity doesn’t aggravate pain
- Listening to music.
- Get enough rest.
6. Lose weight
Gaining weight can increase uric acid levels in the body. Fat cells tend to make more uric acid than muscle cells obviously. Besides reducing stress, exercise makes your body to lose weight which reduces uric acid levels.
7. Eating More Cherries
It should be noted, cherries high levels of anthocyanins which are anti-inflammatory compounds. The researchers found that cherry has symptom reducing benefits.
In addition, they also found that cherries reduce 75% of the risk of a person who also took gout medications.
8. Drinking Lemon Water
A 2015 study has mentioned that adding the juice of two freshly squeezed lemons in two litres of drinking water each day reduce the uric acid levels in gout.
To be clear, they concluded that lemon water neutralizes uric acid levels in the body, thus helps to reduce the levels.
9. Choose A Healthy Diet
9. What Are The Foods To Avoid Gout?
- Foods High In Purine Levels- red meat, organ meat, seafood, poultry
- Sugary Drinks And Foods that are high in fructose. The faster absorption of refined sugars spikes the blood glucose level and the higher amount of uric acid.
- Alcohol And High Liquor- they are high in purines levels.
- Caffeinated Beverages- Caffeinated beverages affect the waste removal function of your kidneys by increasing the urine output. This can eliminate too much water from your body which results in dehydration. To clarify, dehydration can result in higher concentrations of uric acid levels in your body fluids. But some research studies show that coffee reduces gout risk.
10. Difference Between Gout And Pseudogout
As we have seen earlier, high uric acid levels cause gout. High calcium pyrophosphate levels are responsible for causing Pseudogout (known as false gout). Pseudogout is also a form of arthritis. It is characterized with painful swelling in one or more of joints. The most common affected area is the knee.
It isn’t clear why these crystals form in the joints but it increases the risk among the higher age people.
11. Cormorbidities Of Gout
Acute attacks for gout occurs more and more often if it is left untreated. Therefore, the high uric levels cause inflammation which also leads to tophi ( known as tophaceous gout). It causes damage to joint issues, bone erosion can lead to the complete destruction of the joint.
In addition, the high uric acid levels in the body can also lead to the formation of urate crystals in the joints which can also affect the kidney in the form of kidney stones.
According to National kidney foundation, many people who have kidney disease are also related to gout. In some cases, they also have kidney failure.
In addition, gout is common in people who have high blood pressure, coronary artery diseases and heart failure.
To conclude, seek medical care immediately if are experiencing the above condition. Condition will get worsened if left untreated.