Gout is a frequent and complicated kind of arthritis that can afflict anyone at any age. It is distinguished by abrupt, acute episodes of pain, swelling, redness, and tenderness in one or more joints, most often the big toe.
Gout attacks can be severe, waking you up in the middle of the night with the sensation that your big toe is on fire. The injured joint is heated, swollen, and so sensitive that even the weight of the bedsheet may feel unbearable.
Gout symptoms might come and go, but there are strategies to control them and avoid flare-ups.
WHAT ARE THE SYMPTOMS OF GOUT?
Gout symptoms nearly always appear quickly and frequently at night. They are as follows:
- Joint pain that is excruciating: Gout typically affects the big toe, however it can affect any joint. Ankles, knees, elbows, wrists, and fingers are all often afflicted joints. The pain is most likely to be severe in the first four to twelve hours after it begins.
- Persistent discomfort: Some joint discomfort may last from a few days to a few weeks after the most severe pain has subsided. Later episodes are more likely to be more severe and impact more joints.
- Redness and inflammation: The affected joint or joints swell, become tender, heated, and red.
- Restricted motion range: You may be unable to move your joints normally as your gout advances.
WHAT ARE THE CAUSES OF GOUT?
Gout occurs when urate crystals build up in your joint, causing inflammation and excruciating pain. Urate crystals can form in the presence of high levels of uric acid in the blood. When your body breaks down purines, which are naturally occurring chemicals in your body, it generates uric acid.
Purines can also be found in some foods, such as red meat and organ meats like liver. Anchovies, sardines, mussels, scallops, trout, and tuna are examples of purine-rich seafood. Alcoholic beverages, particularly beer, and drinks sweetened with fruit sugar (fructose) raise uric acid levels.
Uric acid normally dissolves in your blood and goes into your urine via your kidneys. However, your body can create too much uric acid or your kidneys can discharge too little. When this occurs, uric acid can accumulate, generating sharp, needlelike urate crystals in the joint or surrounding tissue, causing pain, inflammation, and swelling.
WHAT ARE THE RISK FACTORS FOR GOUT?
If you have excessive uric acid levels in your body, you are more prone to develop gout. The following factors contribute to a rise in uric acid levels in your body:
- Diet: Consuming a diet high in red meat and seafood, as well as beverages sweetened with fruit sugar (fructose), raises uric acid levels, increasing your risk of gout. Gout is also exacerbated by alcohol intake, particularly beer.
- Weight: When you're overweight, your body creates more uric acid, and your kidneys have a harder difficulty removing it.
- Some medicines: Low-dose aspirin and various hypertension drugs, such as thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and beta blockers, can also raise uric acid levels. Anti-rejection medicines provided for organ transplant recipients might also be harmful.
- Family history of gout: You are more prone to acquire gout if other members of your family have had the disease.
- Age and gender: Gout is more common in men, owing to the fact that women have lower uric acid levels. However, after menopause, women's uric acid levels approach those of men. Men are also more prone to get gout at a younger age, typically between the ages of 30 and 50, whereas women typically acquire symptoms after menopause.
- Trauma or recent surgery: A gout episode can occasionally be triggered by recent surgery or trauma. Receiving a vaccine can cause a flare-up of gout in some people.
- Medical problems: Gout is made more likely by several disorders and circumstances. Untreated high blood pressure and chronic disorders such as diabetes, obesity, metabolic syndrome, and heart and kidney disease are examples of these.
WHAT ARE THE COMPLICATIONS OF GOUT?
Gout patients may develop more serious conditions, such as:- Recurrent gout: Some people may never again suffer gout symptoms. Others may get gout many times a year. In those with recurrent gout, medications may help prevent gout attacks. Gout, if left untreated, can cause joint erosion and damage.
- Advanced gout: Untreated gout can cause urate crystal deposits under the skin to accumulate in nodules called tophi. Tophi can appear in a variety of places, including your fingers, hands, feet, elbows, and the Achilles tendons down the backs of your ankles. Tophi are normally not unpleasant, although they can swell and become sore during gout bouts.
- Kidney stones: Urate crystals can form in the urinary tracts of gout patients, creating kidney stones. Medications can help minimize the chances of developing kidney stones.
HOW IS GOUT DIAGNOSED?
Gout is often diagnosed based on your symptoms as well as the look of the afflicted joint. Gout diagnostic tests may include:
- Joint fluid test: A needle may be used by your doctor to drain fluid from your damaged joint. When the fluid is viewed under a microscope, ureate crystals may be detected.
- Blood test: A blood test to determine the amounts of uric acid in your blood may be recommended by your doctor. However, blood test findings might be deceptive. Some people have elevated uric acid levels but never develop gout. And other patients have gout symptoms but no abnormal amounts of uric acid in their blood.
- X-ray imaging: Joint X-rays can help rule out other potential causes of joint inflammation.
- Ultrasound: Sound waves are used in this technique to identify urate crystals in joints or tophi.
- Dual-energy computerized tomography (DECT): To visualize urate crystals in joints, this technique combines X-ray pictures acquired from several angles.
WHAT ARE THE TREATMENTS FOR GOUT?
Gout drugs are classified into two categories that address two distinct issues. The first type relieves the inflammation and pain caused by gout attacks. The second type aims to prevent gout complications by reducing uric acid levels in the blood.
The sort of medication that is best for you is determined by the frequency and intensity of your symptoms, as well as any other health issues you may have.
Medications for treating gout attacks
Among the medications used to treat gout flare-ups and prevent future attacks are:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter NSAIDs include ibuprofen (Advil, Motrin IB, and others) and naproxen sodium (Aleve), as well as stronger prescription NSAIDs such indomethacin (Indocin, Tivorbex) or celecoxib (Celebrex). NSAIDs have the potential to cause stomach pain, bleeding, and ulcers.
- Colchicine: Colchicine (Colcrys, Gloperba, Mitigare), an anti-inflammatory medicine that efficiently relieves gout pain, may be prescribed by your doctor. The drug's efficacy, however, may be outweighed by adverse effects such as nausea, vomiting, and diarrhea.
- Corticosteroids: Prednisone and other corticosteroid medicines may help decrease gout inflammation and discomfort. Corticosteroids can be taken orally or injected into your joint. Corticosteroids can cause mood changes, increased blood sugar levels, and high blood pressure.
Medications for preventing gout complications
If you have numerous gout episodes per year, or if your gout attacks are less frequent but more painful, your doctor may advise you to take medication to lower your risk of gout-related problems. If joint X-rays show indications of gout damage, or if you have tophi, chronic kidney disease, or kidney stones, uric acid-lowering drugs may be prescribed.
- Medications that prevent the formation of uric acid: Allopurinol (Aloprim, Lopurin, Zyloprim) and febuxostat (Uloric) are medications that help restrict the quantity of uric acid your body produces. Allopurinol side effects include fever, rash, hepatitis, and kidney issues. Rash, nausea, and decreased liver function are among the side effects of fuxostat. Febuxostat may also increase the risk of cardiac failure.
- Medications that facilitate the elimination of uric acid: Probenecid (Probalan) and other drugs assist your kidneys remove uric acid from your body. A rash, gastrointestinal ache, and kidney stones are among the side effects.
HOME REMEDIES FOR GOUT
Medications are frequently the most efficient method of treating gout attacks and preventing repeated symptom flares. However, lifestyle decisions are crucial as well, and you may wish to:
- Select healthier beverages: Limit your intake of alcoholic beverages and drinks sweetened with fruit sugar (fructose). Instead, consume plenty of nonalcoholic beverages, particularly water.
- Purine-rich foods should be avoided: Purines are particularly abundant in red meat and organ meats such as liver. Anchovies, sardines, mussels, scallops, trout, and tuna are examples of purine-rich seafood. Low-fat dairy products may be a superior source of protein for gout sufferers.
- Exercise daily and lose weight: Maintaining a healthy weight lowers your risk of gout. Low-impact exercises such as walking, bicycling, and swimming are better for your joints.