A gout is a form of arthritis caused by the deposition of crystals of uric acid in a joint. Gouty arthritis is a condition caused by the buildup and accumulation of excessive uric acid in the bloodstream and in the tissues. It results in symptoms such as tophi, which are nodules found under the skin, joint pain, joint redness and swollen joints. If it is not treated, it will lead to damage in the joints, kidney failure and tophi (1).
What Are The Risk Factors?
Gout attacks occur abruptly and intermittently. It harms the tissues in the region of the inflammation. It can further increase the chances of cardiovascular and metabolic diseases. Men are more prone to the attacks, but women can suffer from it, especially after menopause. Research has discovered that obesity, excessive weight gain and hypertension are among the risk factors for its development. One of the biggest factors that causes gout is the excessive intake of alcohol.
The other risk factors are the following:
- Heart disease.
- Diabetes.
- Hyperuricemia.
- Renal disease.
- Renal insufficiency.
- Elevated triglyceride.
- Elevated cholesterol levels.
- Menopause.
- Undergoing surgery.
- Elevated creatine levels.
Research also indicated that the consumption of dairy, meat, seafood, fruit and purine-rich vegetable were risk factors as well (2). Even some medications may be a risk factor such as water pills, which raise the level of uric acid in the bloodstream.
Take Home Note:
Men are more susceptible to attacks of gout than women, although, women may be affected by it after menopause. Some of the risk factors are excess consumption of alcohol, renal disease, diabetes, undergoing surgery and even a high consumption of meat and seafood.
Symptoms
A gout attack results in extreme pain in the joints, which leads to warmth, swelling, reddish discoloration and marked tenderness. The part of the body that is mostly affected by the attacks is the small joint in the big toe. Besides the big toe, ankles, as well as knees, fingers and wrists, are susceptible to the attacks.
In certain cases, people experience such drastic pain by the attacks that when their toe makes contact with linen, they experience excruciating pain. The attacks, usually, are subdued in a matter of hours or days. There have been cases reported where the pain of the attack vanished only a few weeks after the onset. People who have suffered from the attacks will experience several recurring incidents in the future (3).
If the attacks are not treated in the one joint, the pain may spread to other joints. Tophi develops under the skin, around the joints and may form kidney stones.
Take Home Note:
The pain of the attacks are usually found in the toe, but other joints such as knees, wrists and fingers may be affected as well. The attacks can last for several hours or days and may dissipate with or without medication. People who previously suffered from gout attacks will encounter future attacks.
Diet
The most important thing to incorporate into your diet is to limit the amount of foods that contain a high levels of purine. Preferably, you should consume minimal of these foods or none. Foods that contain a high level of purine are fish, seafood, shellfish, anchovies, sardines, mackerel, scallops and mussels. Meats that contain a high level of purine are bacon, turkey, liver, beef kidney and sweetbreads.
- Weight loss – studies have shown that by limiting the intake of calories and losing weight, it reduces the level of uric acid and pressure on the joints.
- Complex carbs – you need to eat a lot of fruit, vegetables and whole grains as these foods supply complex carbohydrates. The foods that you should stay clear of include cakes, candy, sugar-sweetened beverages and foods that contain high-fructose corn syrup.
- Water – it is essential that you consume a high intake of water. You should set a target of at least 8 glasses a day, preferably 16 glasses.
- Fats – red meats contain a tremendous amount of red fats that should be avoided as well as fatty poultry and dairy products that contain a high level of fat.
- Proteins – if you consume foods that contain protein such as fish, lean meat and poultry, you need to limit the intake to 4 to 6 ounces. Foods that contain the right level of protein are low-fat yogurt and skim milk (4).
Health experts have recommended foods such as organ and glandular meats, selected seafood, vitamin C, coffee and cherries to include in your healthy diet.
Take Home Note:
Limit the intake of foods that consist of a high level of purine. Shellfish, mussels, anchovies, bacon and turkey are examples of foods to avoid. Incorporate exercise to lose weight, complex carbs, high consumption of water, vitamin C and coffee to avoid the possibility of gout attacks.
Diagnosis Of Gout
The testing for gout is done by detecting uric acid crystals in the joint fluid obtained by joint aspiration. The procedure is conducted by using topical local anesthesia. By making use of the sterile strategy, fluid is withdrawn from the inflamed joint with the use of a syringe and a needle. When the joint fluid is extracted, then it has to be examined for uric acid crystals. The doctor might do a blood test to determine the amount in the blood, and any infection (5).
X-ray imaging may be used to determine the causes of joint inflammation. The other diagnosis for the condition is an ultrasound, which is able to pick up any urate crystals in a joint or in a tophus. Dual-energy CT scans detect urate crystals even when it is not acutely inflamed (6).
In order to treat gout attacks and prevent further outbreaks, medication will need to be taken. The drugs that may be used include nonsteroidal anti-inflammatory drugs (NSAID), Colchicines and Corticosteroids.
