Gout
Miss Anjali (name changed) went to a coastal area for a family vacation for a week. And as coastal areas are famous for their non-vegetarian, especially seafood like crabs, prawns, oysters, etc; they had a wonderful time eating these delicacies every day (almost at every meal). However, on the last day, Anjali experienced stiffness in her fingers accompanied with pain in her joints. The condition was so severe that she couldn’t hold her bag/ a bottle. When she finally arrived at her place, she visited her doctor only to know that she suffered from gout.
What is gout?
Gout is a type of rheumatic disease caused by high levels of uric acid in the blood. But not everybody with increased blood levels of uric acid gets gout. It occurs when uric acid levels in the blood are very high, which in turn leads to the deposition of hard crystals in the joints. Also known as inflammatory arthritis, it causes sudden and severe episodes of pain and swelling in the joints.
Symptoms
Gout is detected once you experience the first attack. However, there are few signs that can help you to identify the condition in its initial stage. Here they are –
- Peeling of skin
- Tophi
- Fever
Also, gout is characterized by a sudden attack of burning pain, stiffness and swelling in the joints. It can attack the ankles, heels, knees, fingers, elbows and wrists apart from big toes. Here are 6 warning signs to differentiate arthritis from usual joint pain.
Causes
Uric acid is a by-product of protein metabolism, which is excreted from the body through urine. However, in some cases there is an imbalance in the excretion and production of uric acid in the body – a condition known as hyperuricemia. This in turn leads to the deposition of urate crystals in the tissue and between the joints due to --
- Overproduction of uric acid or
- Decreased excretion by the kidneys or
- Both
Here are some common causes for elevated uric acid levels.
Types
Gout is a common form of inflammatory arthritis, especially in men. It may remit for long periods, followed by flare-ups for days to weeks, or can become chronic. Gout is classified into four different stages namely –
Asymptomatic stage – In this stage, there is the deposition of uric acid crystals in the tissue but people do not show any symptoms. It indicates that hyperuricemia is causing the damage. Read in detail about top 6 diseases that can trigger joint pain.
Acute stage – This is the second stage in which people suffering from gout experience acute flares. It is characterized by mild or excruciating pain, redness, swelling and warmth in the affected area.
Interval stage – It is the stage between two subsequent attacks of gout. Although you may not experience pain, it doesn’t signify that the condition is treated. In fact, this is the right time to manage your condition with medications and lifestyle changes to prevent future attacks.
Chronic stage – If your blood uric acid levels remain high for a long time, it signifies chronic gout. The symptoms become more frequent with severe and sudden pain (which usually lasts for few days or weeks). In rare cases, joint damage can lead to loss of mobility. You can prevent this condition with proper treatment and effective management.
Here are 5 expert tips to live well with gout.
Risk factors
There are several factors that put you at risk of suffering from gout. These include –
Gender: Gout is common in men as compared to women (till they reach menopause). It is believed that estrogen hormone protects women from gout.
Age: There is a high risk of getting gout if you are above 60 years. This is due to various functional changes that occur with age.
Genes: If you have a family history of gout, then the chances of suffering from this disease is comparatively high.
Overweight: In case you are overweight or obese, you are more likely to suffer from gout due to excess production of uric acid in the body.
Medications: Medications such as diuretics or those taken by people suffering from rheumatoid arthritis and psoriasis or patients who underwent a transplant, increase your uric acid levels thereby elevating your risk of gout.
Purine-rich foods: Eating too much of meat and fish that are high in chemicals called purines also increase your chances of getting gout.
Artificial fruit juices and soft drinks: They contain artificial sweeteners and citric acid that in turn put you at risk of gout. They not only increase your uric acid levels but also worsen the symptoms.
Certain diseases: If you are suffering from hypertension, diabetes, heart disease or kidney diseases, your chances of developing gout are quite high.
Excessive drinking: Although alcohol has numerous side-effects one more reason to cut down your intake of alcohol is that it puts you at risk of gout.
Diagnosis
Diagnosis of gout is based on the symptoms that you experience. Your doctor might also enquire about family history and also medical background. Depending upon the symptoms, you might be recommended a blood test to detect the presence of uric acid crystals in synovial fluid. A high level of uric acid level in the blood does not necessarily indicate gout and thus, tests to rule out other potential causes of inflammation might be recommended. These include –
X-ray, ultrasound, and MRI – This is used to detect inflammation of soft tissue and bone. Here’s everything you should know about MRI.
Microscopic analysis – It involves examination of fluid from the affected joint for uric acid crystals under a microscope. Positive results indicate gout.
Here are 7 diagnostic tests to find out ifyour joint pain is due to arthritis.
Treatment
Medications form the first line of treatment to deal with gout. If the symptoms are present for many years leading to the formation of tophi (chalky substances), surgical intervention might be needed. The common medications that are prescribed include –
NSAIDs (Non-steroidal anti-inflammatory drugs): These drugs are used to treat acute attacks and also prevent you from future attacks of gout.
Pain relievers: As joint pain is one of the most common symptoms of gout, painkillers are usually prescribed (along with NSAIDs in some cases). Know more about painkillers or analgesics: side-effects and precautions.
Steroids: If you cannot take either NSAIDs or pain relievers, your doctor might recommend corticosteroids to ease your pain and inflammation. These are available in the pill form and also in the form of an injection.
Also, your doctor might recommend medications that lower your risk of future attacks and/ complications associated with the condition. These include –
- Medications that block the production of uric acid in the body (such as allopurinol)
- Medications that help in eliminating the excess uric acid from the body (such as probenecid)
Here is how you can reduce uric acid levels naturally.
Home remedies
Here are some remedies that may ease pain and swelling, common in gout patients –
- Cherries
- Apple cider vinegar
- Banana
- Ginger
- Lemon juice
Here is detailed explanation on these five home remedies to treat gout effectively.
Complications
Some of the common health complications caused due to gout are -
Joint damage – Some people might experience symptoms of gout quite frequently and thus, need proper medical treatment. If left untreated, such recurrent attacks of gout can cause joint damage due to the constant erosion of the joints and inflammation.
Tophi – If you are suffering from gout for a year or your condition is not treated, uric acid crystals tend to deposit leading to the formation of tophi (clustered granules ofurate). They can develop under the skin or in the joints of your hands, elbow or ankles. Although they are not painful, they become swollen. Also read about 12 causes of swollen joints.
Kidney stones – There are high chances that urinate crystals might get collected in the urinary tract leading to the formation of kidney stones. Hence, you need to take medications to treat gout and lower your risk of kidney stones.
Prevention
To lead a healthy life with gout, here’s what you should keep in mind.
- Avoid eating foods that are rich in purines like meat and fish (5 diet dos and don’ts for people suffering from gout)
- Lower your intake of alcohol
- Eat foods that are low in fat content
- Follow your doctor’s instructions
- Take medications regularly
- Include cherries in your diet (as it can lower the risk of gout attacks)
Also read in detail about 7 tips to reduce uric acid level and prevent gout.
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