Everything About Gout

When we talk about gout, it pertains to a group of clinical conditions that arise when uric acid builds up. This phenomenon usually occurs on a person’s feet.

People who have gout feel the pain and swelling that radiates from the joints of their foot, affecting the big toe most of the time. The unforeseen intense pain is referred to as gout attacks, and it gives a burning sensation in the foot.

Gout Symptoms

There are people who don’t feel any symptoms, despite the high level of uric acid in the blood. This is referred to as asymptomatic gout.

But for acute gout, symptoms appear quickly as the uric acid crystals build up in the joints. It can last for around 3 – 10 days.

During acute gout attacks, severe pain and swelling may be experienced. The joints may also feel more warm. Before and after gout attacks, you will not feel any symptoms.

Failure to treat gout may lead to chronic conditions. Tophi or hard lumps eventually develop both in the skin, joints and the surrounding soft tissues. Such deposits can damage the joints permanently.

Early treatment of gout is highly encouraged to prevent it from occurring on a long-term basis (chronic). So determining the symptoms can definitely help anyone to schedule a consult to the doctor right away to prevent the gout from causing permanent issues.

What causes gout

Uric acid builds up in the blood when purines are broken down. This is what causes gout.

Some conditions, especially those affecting the metabolism and blood, can trigger the body to produce high uric acid in the blood. Dehydration also contributes to this event.

Conditions affecting the kidney and thyroid gland, as well as inherited disorders, make it difficult for the body to remove too much uric acid.

The following conditions increases the risk of having gout:

  • drinking alcohol
  • middle-aged men and women of postmenopausal stage
  • have siblings, parents, and other family relatives with gout
  • having comorbidities such as hypertension, thyroid problems, kidney disease, sleep apnea and diabetes
  • taking medicines like cyclosporine and diuretics (promotes urination)

Diet plays a role in some people who have gout. Certain foods contain high amounts of purines, the substance associated with gout.

How is Gout diagnosed

The physician will diagnose gout after reviewing the patient’s medical history, symptoms and the result of the physical exam. Particularly, your doctor will base it on the following:

  • the manner you describe the joint pain
  • frequency of experiencing severe pain in the joint
  • the redness or swelling of the area

The doctor may check for uric acid build up in the joint by ordering a test. This is done by taking a fluid sample from the patient’s joint. This test will reveal whether it has uric acid or not. An X-ray may also be ordered by the doctor to examine the joint.

If you experience any symptoms of gout, you may schedule a consultation with a primary care doctor as it persists. If it becomes severe, a joint disease specialist may be needed.

How to treat gout

One problem with gout is when it is left untreated, it may lead to arthritis. This condition is painful and can leave permanent damages and swelling on the joint.

Depending on severity and stage of the gout, your physician will recommend a plan that suits you best.

Medications for treating gout may work in one of the known two ways: relieve the pain by alleviating the inflammation, or preventing gout attacks in the future by lowering the levels of uric acid in the blood.

Some drugs that relieve painful gout are:

  • ibuprofen (Advil, Motrin), aspirin (Bufferin), naproxen (Aleve) and all the other nonsteroidal anti-inflammatory drugs (NSAIDs)
  • corticosteroids
  • colchicine (Mitigare or Colcrys)

Drugs that prevent gout attacks include:

  • xanthine oxidase inhibitors – includes allopurinol (Zyloprim or Lopurin)
  • febuxostat (Uloric)
  • probenecid (Probalan)

Aside from medications, your physician might recommend some changes in your lifestyle. This will help manage the symptoms and minimize the risk of gout attacks in the future. For instance, the doctor will encourage you to do the following:

  • lose weight
  • reduce alcohol intake
  • quit smoking

Medication, in conjunction with lifestyle modification, is not the sole way of managing gout. A few good substitute ways have also shown good impact.

Foods that triggers gout

Some foods are known to be rich in purines, the substances that our body metabolizes into uric acid. While some people don’t get an issue with a high-purine diet, others may have a body that finds it difficult to excrete too much uric acid. Here are some foods or drinks with high purine composition that you need to avoid:

  • organ meats
  • red meats
  • alcoholic drinks
  • some seafood

Some beverages sweetened by sugar and foods that contain fructose (a type of sugar) may also cause problems despite the fact that they don’t contain purines.

In order to lower down the levels of uric acid in the body, some foods may help. So it is important to learn the foods that help in avoiding gout.

Home remedies for gout

The relief for gout doesn’t come in medications sometimes. Studies have proved that such natural remedies reduces the levels of uric acid in the blood and further prevent gout attacks:

  • magnesium
  • tart cherries
  • ginger
  • celery
  • apple cider vinegar
  • nettle tea
  • milk thistle seeds
  • dandelion

But eating these foods alone does not guarantee  permanently curing gout. 

Surgery for Gout 

Typically, gout is treatable even without surgery. But over the years, this painful condition can cause damage in the joints, make the tendons torn, and allow infections to grow in the skin above the joints.

Tophi or hard deposits tend to build up on the joints but can also occur in other regions like the ear. Any of these lumps manifest as painful swelling. If left untreated, it could leave permanent damage to the joints.

Three surgical procedures treat tophi:

  • Joint fusion surgery
  • surgical removal of tophi
  • joint replacement surgery

The type of surgery the doctors will select relies on the damage extent, the region where the tophi is located. Your personal preferences will also be considered. With surgery, joints affected by gout can be stabilized and prevent further damage.

What triggers Gout

Foods, comorbidities and medications contribute to gout flare-ups. Here are some known food and drinks with high purine content which you must limit of avoid:

  • red meat like veal and pork
  • fish (includes scallops, salmon and mussels)
  • organ meat
  • alcohol
  • fruit juice
  • soda

On the other hand, some drugs used to treat other diseases indirectly raise uric acid levels in the blood. Discuss it with your doctor if you take at least one of these medications:

  • Diuretics (drugs that promotes urination)
  • Aspirin (blood thinner)
  • Angiotensin II receptor blockers (antihypertensive)
  • Beta-blockers (lowers blood pressure and heart rate) 

The pre-existing health condition may also play a part in acute attacks of gout. The following clinical conditions are associated with gout:

  • diabetes (even pre-diabetes)
  • obesity
  • dehydration
  • infection
  • joint injuries
  • congestive heart failure (CHF)
  • renal disease
  • hypertension

Since the list could go on, it can be difficult to confirm which among these factors is causing the gout attacks. One way to keep track of your diet, health condition, and medication is by maintaining a diary. This method could help in diagnosing the cause of the symptoms.

Preventing Gout

When it comes to preventing gout, here are some few helpful steps to prevent it:

  • Limit daily alcohol intake.
  • Consider a non dairy diet with low in fat
  • Limit the intake of purine-rich foods like shellfish, beef, lamb, pork, as well as organ meat
  • Lose weight
  • Quit smoking
  • Stay hydrated by drinking enough water every day
  • Exercise regularly

If you are taking medications for any medical conditions that may raise the risk of aggravating gout, ask your physician about the ways to lower the risk.

As uric acid crystals accumulate in the joints over an extended period of time, they form hard deposits under your skin known as tophi. These substances can bring damage in the cartilage and bone, leaving the joints deformed permanently if not treated.

Tophi are swelling lumps surrounding the joints that resemble tree trunk knots. They can affect joints such as in the fingers, ears, foot, and knees. The tophi themselves aren’t unpleasant, but the resulting inflammation can be.

Outside of the joints, tophi can develop in connective tissue. Some of them may be found in the most odd locations.

Is gout a painful condition?

Yes, gout is a painful condition. Patients frequently describe discomfort in the big toe as one of the initial symptoms. Usual arthritic symptoms, such as swelling and warmth in the joints, accompany the pain.

The intensity of gout pain varies. At first, the pain  in the big toe might be excruciating. It may decrease to a dull pain after the initial onset.

The pain, swelling and other symptoms are caused by the body’s immune system as  it launches a fight against the uric acid crystals. The production of molecules known as cytokines, which cause severe inflammation, is triggered by this onslaught.

Essential oils for gout

Aromatherapy uses essential oils, which are plant-based compounds. Anti-inflammatory, pain-relieving, and antimicrobial properties are thought to exist in certain oils.

The following are few of the essential oils that are employed to treat gout:

  • lemongrass oil
  • celery seed oil
  • yarrow oil extract
  • olive leaf extract
  • Chinese cinnamon

You may inhale the oils, apply the diluted oil on your skin, or brew tea with the plant’s dried leaves. Simply avoid putting the oils into your mouth as they are unsafe to eat.

It is suggested to talk with a doctor before trying any alternative therapy, even if it’s something as safe as essential oils. If you do decide to use these oils, make sure you take the necessary measures to avoid an allergic response.

Is gout a hereditary disease?

Gout has something to do with genes. SLC2A9 and ABCG2 are two of the hundreds of genes linked to gout risk as discovered by researchers. The quantity of uric acid the body stores and releases is affected by genes linked to gout.

Gout runs in a family’s blood due to hereditary reasons. People who have a sibling, parent, or other close relative with gout are more prone to get the disease.

Genes are most likely only a catalyst for gout. Some environmental variables, such as nutrition, have a role in the disease’s onset.

Alcohol and gout

Purines are abundant in alcohol, as well as seafoods and red meat. Uric acid is produced when your body breaks down purines.

Gout is more likely to occur if you have a lot of uric acid in your system. While alcohol can also slow down the removal of uric acid from your body.

Gout does not affect everyone who drinks. However, excessive alcohol intake (beyond 12 drinks in a week) might raise the risk, particularly in men. Of all alcoholic drinks, beer is more likely to increase the risk.

According to surveys, most people have reported that alcoholic beverages trigger their gout attacks. Therefore, changing one’s drinking habits may prevent gout over time.