Gout is a kind of arthritis. People with gout either have a problem in removing uric acid from their body or produce too much uric acid.
It is a common disorder of uric acid metabolism that can lead to recurrent episodes of joint inflammation, stiffness in joints, sudden burning pain and swelling in the joints. If untreated, gout can harm joints, tendons and other tissues.
In some cases, gout may first appear as nodules (tophi) on the hands, elbows or ears. By the time the symptoms of a gout attack appear, uric acid deposits have already been formed on the joints due to uric acid buildup.
A red, swollen joint is the first symptom of gout arthritis, the base of the big toe is the most common joint. The first attacks of pain and swelling go away after one or two weeks, but returns in the same another joint.
Following are the symptoms of gout:
- The most common sign of gout is swelling, redness, tenderness and sharp pain usually in the big toe in night. This symptom is called podagra.
- Very red or purplish skin around the affected joint.
- Intolerable and intense pain starting during the night. The acute pain may be so intense that even a bed sheet on the toe causes severe pain.
- Limitation of movement in the affected joint.
- Rapid increase in discomfort in the night, lasting for some hours and then easing during the next few days.
- After the gout attack subsides, the skin around the affected joint may peel and feel itchy.
- Joint deformation and destruction can happen if several attacks of gout occur each year.
- Kidney stones may be present in people with gout.
- Uric acid crystals can collect (known as tophi) outside joints such as the earlobe, elbow, and Achilles tendon (back of the ankle). These tophi are not painful but can be a valuable clue for the diagnosis.
The gout attack can last a few days to many weeks. Another attack may not happen for months or years. The difference between other arthritis such as rheumatoid arthritis and gout is that while the former usually affects multiple joints simultaneously, the gout generally attacks one joint at a time.
Gout usually develops after about 20 years of buildup of uric acid crystals in the joints and surrounding tissues.
Approximately 1% of the population is affected with gout, more common in men than women. In women, gout usually occur after menopause, while in men after puberty.
The big toe joint is most commonly affected by gout. The joints of the feet, knees, ankles, elbows, wrists and fingers may also be affected.
Recurrence of gouty arthritis can damage the joint and lead to chronic arthritis.
How it is diagnosed?
Gout is diagnosed by noting the symptoms and physical examination of the body joints by the Doctor. A blood test is done to measure the amount of uric acid in the blood. A sample of fluid from the joint is tested for the uric acid crystals.
- It is caused by too much uric acid in the blood or decreased elimination of uric acid by the kidneys. The uric acid may form hard crystals in the joints. When uric acid level in blood exceeds 6.8 mg/dL, uric acid can crystallize.
Men develop gout at an early age after puberty because uric acid levels because uric acid levels increase at puberty, while women develop after menopause.
- Uric acid is a byproduct of purine metabolism. Those people who produce excessive amounts of uric acid or are unable to excrete sufficient amounts of uric acid in their urine can have gout attacks. However, many people with high levels of uric acid in the blood never develop gout.
10% of people with gout generate too much uric acid.
Most people with gout do not effectively eliminate their uric acid into the urine.
- Drinking of too much beer increases the risk for gout.
- Diets rich in red meats, yeast, internal organs and oily fish increase the risk for gout.
- Genetic & Racial Causes
You have a chance of developing gout if your parents have gout.
American blacks (not African blacks), British people are more likely to develop gout than other populations.
- Gout attack can be precipitated when there is a sudden change in uric acid levels, which may be due to drinking too much alcohol, eating red meats, dehydration, starvation, trauma, chemotherapy and certain medications such as aspirin, diuretics and some hypertensive medications.
The following risk factors can make joints more susceptible to the formation of uric acid crystals and gout.
- If you are overweight.
- If you drink alcohol too much, specially beer. Alcohol causes gout by slowing down the excretion of uric acid from the kidneys, thereby increasing the level of uric acid. It also cause dehydration, which precipitates the crystals in the joints.
- Foods that cause gout: If you eat too much meat and seafood that are high in chemicals called purines, since purine chemicals are converted by the body into uric acid. Purines rich foods include shellfish and organ meats such as brains, kidneys, liver, etc.
- Very low-calorie diets can flare up gout.
- Some medicines such as heavy use of aspirin, diuretics (water pills) and cyclosporine can cause gout. Cyclosporine suppress the immune system.
- Chemotherapy that cause rapid cell death can cause gout.
- Certain medical coinditions can cause gout - renal insufficiency, lead poisoning, starvation, hemorrhage, trauma, dehydration, hypothyroidism, hyperparathyroidism, psoriasis, tumors, high blood pressure, etc.
- If you have undergone a surgery.
- If you are a male.
- Your genes may be responsible.
How To Prevent
Gout can be prevented by eliminating the above mentioned risk factors.
- Reduce your weight.
- Reduce alcohol consumption, if you drink. Alcohol can affect uric-acid metabolism and cause hyperuricemia.
- Maintain adequate fluid intake.
- Dietary changes as mentioned on gout diet.
- Low fat dairy products can reduce the risk of gout.
- Gout- Wikipedia, the free encyclopedia
- Gout Symptoms - Arthritis Foundation
- Gout - Arthritis & Osteoporosis NSW
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