Everything About Gout

Introduction

Increased uric acid levels in the body cause gout, resulting in the formation of sharp crystals in the big toe or other joints. These cause episodes of swelling and pain, commonly known as gout attacks. Gout is a treatable condition with medications and specific changes in diet and lifestyle.

What Is Gout?

Gout has been placed under the broader classification of arthritis, which is a wide range of joint disorders and pain. Some forms of arthritis cause joint inflammation, whereas others have much milder symptoms. Usually affecting the big toe, the condition can also affect other joints such as the knee, ankle, foot, hand, wrist, and elbow, depending upon the concentration and formation of uric acid crystals.

Who Are More Prone to Developing Conditions?

Gout usually occurs earlier in males than in females, and it generally occurs in post-menopausal women. Men are three times more predisposed than women to develop the condition because their metabolism causes them to have higher uric acid levels most of their lives and due to their lifestyle choices. Women, however, reach similar uric acid levels in their post-menopausal age.

The general conditions that make any individual more prone to develop gout are enlisted as follows;

• Obesity.

• Congestive cardiac conditions.

• Diabetes mellitus.

• Family history and genetic predisposition.

• Hypertension.

• Chronic kidney diseases.

• Consumption of a diet rich in animal proteins.

• Alcoholism.

• Diuretic drug therapy to treat other conditions.

How Does the Body Develop This Condition?

Uric acid production in the body occurs during the breakdown of chemicals known as purines which may be found in particular food and drinks which go through the kidneys and exit the body by urination. However, sometimes uric acid production in the body may be significantly raised, or kidney function impairment may lead to mishandling of the filtration of the substance. High uric acid levels lead to hyperuricemia, which causes the uric acid crystals to concentrate in the joints. The crystals are needle-shaped, causing pain in the affected joints called gout. However, elevated uric acid levels may never cause gout in specific individuals.

What Is Gout Attack, and What Are Its Signs and Symptoms?

Any episode of extreme gout symptoms is called a gout attack which may be extremely painful and can have a sudden onset, often overnight. During a gout attack, the signs in the affected joint include the following;

• Intense joint pain.

• Redness of the affected joint.

• Stiffness and limited range of motion.

• Swelling of the joint affected.

• Extreme tenderness triggered even with the lightest touch.

• An increased warm feeling in the affected joint.

What Is the Duration of Gout Attacks?

A gout attack usually lasts for a week or two; however, the patient may exhibit little to no symptoms in between episodes.

What Is the Frequency of Gout Attacks?

Gout attacks may be as frequent as episodes occurring every few days or weeks, and in some cases, it may be years between two consecutive episodes. If left untreated, the attack frequency and duration are significantly increased. Gout attacks can be repetitive in the same joint or affect different joints, depending upon the site of uric acid crystal formations.

How Is Gout Diagnosed?

• Symptoms: A good case history is recorded by the attending physician. The pain in the great toe, along with the associated diet and family history of the patient, is taken into consideration.

• Physical Examination: The affected joint is appropriately examined for the signs such as pain, tenderness, and warmth.

• Blood and Urine Examination: The blood and urine samples are tested to determine the levels of uric acids.

• Diagnostic Imaging Tests: X-rays, ultrasound, and magnetic resonance imaging may be done to see the joint.

• Aspiration: The joint may be directly aspirated using a needle, and uric acid crystals are examined under the microscope.

What Are the Treatment Modalities for Gout?

• Non Steroidal Anti Inflammatory Drugs (NSAIDs): These are drugs that help in pain management and swelling. People with kidney diseases, stomach ulcers, and specific health problems should refrain from taking these drugs.

• Colchicine is a drug to manage inflammation and pain if taken within 24 hours of a gout attack administered by oral route.

• Oral and injectable corticosteroids can relieve pain and swelling.

• Treating the Condition: Treatment usually includes over-the-counter drugs;

1. Allopurinol pills.
2. Febuxostat pills.
3. Pegloticase intravenous infusion.
4. Probenecid pills.

Is Gout Preventable?

Although genetic predispositions and other factors play an important role in gout, however, specific changes in lifestyle may prevent it, enlisted as follows;

• Drinking plenty of water to maintain proper kidney function.

• Exercising regularly to stay at a healthy weight.

In order to reduce the intake and increase the clearance of purines from the body, the following substances may be reduced or entirely stopped;

• Alcohol.

• Red meat

• Organ meats such as the liver.

• Shellfish.

• Gravy.

• High fructose drinks.

• Animal proteins.

Certain medications also elevate uric acid levels, including the following;

• Diuretics.

• Immunosuppressants.

When to Contact the Physician or Specialist?

Sudden, intense pain in a joint must be reported right away. If the joint is hot and inflamed, it might be due to gout, and conditions such as infections should be ruled out before deciding the probable line of treatment.

What Are the Complications of Untreated Gout?

If untreated, gout can lead to joints being permanently damaged. A tophus is the excessive build-up of uric acid in joints and soft tissues. Other conditions, such as severe arthritis, kidney stones, and heart disease, can also develop in individuals suffering from gout.

How Is a Gout Attack Managed?

In case of a gout attack, the symptoms can be managed by the following measures;

• Alcohol consumption should be avoided.

• Avoiding sweet drinks.

• Drinking plenty of fluids.

• Elevating the affected joint.

• Ice application on the joint.

• Limiting stress on the affected joint.

Conclusion

Extra uric acid in the body creates sharp, needle-shaped crystals in the joints, leading to swelling and extreme tenderness. It begins from the big toe and can affect other joints. It is a treatable condition, and medication and lifestyle changes are critical facets of managing it. Over-the-counter medications are quite helpful. Several home remedies may also be used.