Gout

Gout is a common type of inflammatory arthritis, resulting from an accumulation of uric acid crystals inside the joint, which causes episodic joint swelling, redness, and pain. Gout is more common among men and rarely occurs in pre-menopausal women. It can be treated and controlled to prevent complications and recurrent gout attacks.  

Causes and Risk Factors of Gout

Gout is caused by a continuously high level of uric acid in the body, which in turn leads to an accumulation of crystalized uric acid around and inside the joints. This can cause sudden and severe pain as well as swelling and inflammation. Like the body’s other waste products, uric acid is produced during the elimination of aging cells. About 70% of the body’s uric acid is produced in the body, while the other 30% usually comes from food consumed.

Factors associated with high levels of uric acid in the body include:
  • Eating foods that stimulate more uric acid production such as high-fructose corn syrup and honey
  • Eating foods that are high in uric acid, e.g. meat, innards, seafood, alcoholic drinks.
  • Illnesses that lead to an overproduction of cells (e.g., cancer, leukemia, and psoriasis)
  • Illnesses that cause the body to produce more uric acid than normal or reduces its ability to flush out all of the uric acid effectively (e.g., obesity, diabetes, high blood pressure, and kidney disease)
  • Use of certain types of drugs that cause a reduction of uric acid excretion via the kidneys
 

Symptoms of Gout

Gout patients experience acute and sudden inflammation (pain, redness, heat, and swelling) around the affected joint. Gout usually starts from the joint at the base of the big toe, but it can also affect other joints of the feet, as well as joints of the knees and hands. Gout may come and go at first, but if it is not treated properly, the inflammation may become more severe, causing the patient to feel pain more frequently, develop more frequent attacks and/or longer durations of attacks. This in turn can lead to chronic arthritis or permanent joint damage, and can cause other complications such as kidney stones or kidney failure.
 

Diagnosis of Gout

In addition to a physical examination, doctors can diagnose gout using the following methods:
1. The doctor may take fluid from a swollen joint to check whether it contains uric acid crystals. This is the main confirmative method for the diagnosis.
2. The doctor may take a blood sample to measure the uric acid level. However, a high level of uric acid in the bloodstream does not always mean that the process of crystallization in the joint has begun.
3. A dual energy CT scan is a special type of X-ray which can visualize the accumulation of uric acid crystals inside the joint without requiring a fluid sample. This kind of testing is suitable for cases in which the crystals have bound together to form large deposits, which can be seen by an X-ray.
 

Treatment of Gout

Long-term treatment of gout aims to reduce the amount of uric acid inside the body. There is also an additional treatment to stop joint inflammation during each attack. Affected patients need to take gout medication continuously to prevent future gout attacks and possible complications. As well, medication reduces the risk of the formation of nodules or lumps of crystals in soft tissue, kidney problems, and tophi (a deposit of uric acid crystals).
 

Prevention and Self-Care for Gout Patients

Patients can prevent gout by making lifestyle changes, such as not eating foods that are high in uric acid. In terms of self-care, patients can:
  • Maintain scheduled doctor’s appointments and take any medication as instructed.
  • Avoid foods that are high in uric acid, such as meat (especially poultry), innards, seafood, and alcoholic drinks. Also, avoid fructose (found in carbonated drinks), glucose, corn syrup, and honey, as these can stimulate more uric acid production.
  • Maintain an optimal weight; but do not lose weight too suddenly or too rapidly, as doing so could also increase uric acid levels.
  • Drink an adequate amount of water daily.
  • If you develop an acute gout attack, stop using the inflamed joint until the pain and swelling resolves.

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