Gout: Facts

Gout is an extremely painful form of inflammatory arthritis caused by the build-up of uric acid in the joints. It currently affects about 4% of the population. For most people, gout occurs first in the big toe, where deposits of uric acid (tophie) cause the toe to become red, sore, swollen, and warm.

What Is Gout?

Gout is known to be an inflammatory arthritis condition, which tends to develop in certain individuals who are known to have high levels of uric acid present in their blood. This uric acid is said to form needle-like crystals in the joint region and can lead to severe instances of pain, which may occur all of a sudden. There can also be episodes of swelling, feelings of intensive pain, tenderness, and warmth.

Causes

Gout is said to be caused due to excess amounts of uric acid being present in the bloodstream as well as the accumulation of uric acid crystals, which are found in the tissues of the body. The deposits of uric acid crystals are known to cause inflammation in the joint, thereby leading to acute pain, swelling, and redness in that location. Uric acid is something which is normally found in the human body as a byproduct of the way our body breaks down certain kinds of proteins, which are known as purines. Uric acid is said to be transported to the kidneys by the blood, and from the kidneys they get eliminated in the urine as waste. But in certain individuals, there can be an overproduction of uric acid, or it can be normal production of the acid. But the issue arises when the kidney finds it difficult to process it efficiently, thereby leading to excess build-up of uric acid in the body. But this would not mean that all of those individuals who suffer from this issue will eventually develop gout; it would only be some of those people.

A few of the causes which are related to a rise in the level of uric acid in the blood, or hyperuricemia, are excess weight or obesity, intake of certain medications, a genetic factor, and a reduction in the functioning of the kidneys. Often, gout tends to come on all of a sudden, and initially, it may appear in the form of swelling of the big toe, or there can also be swelling of the lower body joint. But these symptoms are all known to be the end result of a process which has been taking place in the body for quite some time.

Certain other factors, such as one’s current lifestyle, which may include a diet that is high in purine foods, or excessive use of alcohol (mostly beer), can also lead to the development of gout. Below are some of the factors triggering the occurrence of gout in an individual:

• Lifestyle-related factors are: Fasting or starving oneself, crash dieting, alcohol abuse, consumption of sugary sodas, lack of hydration or not drinking enough amounts of water, and consuming larger portions of certain kinds of foods that are high in purine, such as red meat or shellfish.
• Medical or health-related factors are: Existing injury to the joint, infection, severe form of illness, sudden onset of any medical condition, chemo or radiation therapy, consuming a medication known as cyclosporine, starting a treatment that lowers uric acid, or consuming certain diuretic medications for certain illness, such as edema or swelling of the leg, heart disorder, or high blood pressure.

Symptoms

For most individuals, the first few symptoms concerning gout would be excessive pain as well as swelling caused in the big toe, mostly after a trauma, which may include any kind of injury or medical illness. Gout is also known to appear in a lower body joint, which can be the knees or the ankles. As time progresses, there would be subsequent attacks that can occur on and off and in the other joints as well, but mostly affecting the knee or the foot before it can be considered a chronic condition. Gout is said to mostly affect one joint at a time, but if the condition is not treated in a timely manner or if it is left untreated entirely, it can also affect several other joints as well. Joint pain that would ideally be resolved in one weeks’ time to ten days tends to become milder in form and remains as a constant pain. Eventually, gout that has not been treated can also lead to several other issues. There can be the formation of tophi, which is a painless condition, but can lead to disfiguring of the lumps of crystals that are formed from the uric acid, and they often develop just below the skin and around the joints region. These crystals are also known to lead to the formation of kidney stones in an individual. There are other medical conditions which are known to be associated with gout, and those are diabetes, heart-related disorders, high blood pressure, and chronic kidney issues.

Diagnosis

To carry out a diagnosis for gout, the doctor would initially ask for the patient’s medical history. They would then thoroughly check the joint that has been affected, and there would also be a blood sample test. The doctor may ask the patient certain questions regarding any other symptoms being experienced, if the patient is taking any medications or drugs, their diet and lifestyle, and how quickly as well as with what intensity the patient experienced the gout attack. Through questioning, the main purpose of the doctor is to understand how severe the pain is, what the length of the attack is, and which joints have been attacked.

By carrying out various tests, the doctor would first try to rule out the possibility of any other medical condition that is related to joint pain as well as inflammation, which can include any kind of infection, injury, or any other type of arthritis. A blood test would be carried out to check the level of uric acid present in the blood. A rise in the level of uric acid in the blood will not necessarily always be linked with gout, and similarly, a normal level of uric acid also does not mean that there is an absence of gout. The doctor can also carry out an X-ray, CT scan, MRI, or an ultrasound to examine the soft tissues as well as the bones. They can remove the fluid from the joint that has been affected as well and examine this fluid under a microscope for any evidence of uric acid crystals. If there are uric acid crystals, then it is one of the surest ways to confirm the existence of gout in an individual.

Treatment

When an incidence of gout in an individual is mild in form or infrequent, then these can be treated at home by making certain changes in one’s lifestyle and diet. But studies have shown that even carrying out a rigorous diet does not always lead to a lowering of the serum uric acid. Hence, there would be a need for medications. The medications in terms of gout fall under three different categories, which can include uric acid lowering drugs, prophylactic drugs, and rescue drugs that provide immediate relief from the pain caused due to gout. The home remedies for gout would include keeping oneself properly hydrated throughout the day. There can also be certain dietary changes carried out so as to avoid the worsening of symptoms or pain. Certain over-the-counter NSAIDs can be useful, too, if there are no other side effects.