What is Gout?
Also known as metabolic arthritis, gout is a severe form of arthritis. It predominantly attacks the joints, especially the big toe. Burning sensations, pain and swelling are common in cases of gout. The frequency of the attacks usually increases over time. The disease is characterized by elevated levels of uric acid in the blood stream. In this condition, the crystal deposits of monosodium urate (MSU) or uric acid gather around the cartilages of the bones, especially in the joints. It is believed that gout results from a combination of elevated levels of uric acid and the overall acidity of the blood stream. It is found that both the factors are needed for onset of gout. Singly, no one of the factors is enough for developing gout.
Men are more susceptible to gout than the women. However, the chances of getting gout increase heavily after the menopause in women. It is a complex disorder and can affect anyone.
Symptoms of Gout
Gout usually presents acute and sudden attacks of excruciating pain in the joints. The area affected may feel stiff and warm while redness and increased sensitivity may also be present. The pain usually occurs in the toe but it can also affect feet, ankles, knees, wrists and hands. Without treatment, the pain may last for as long as 10 days. The discomfort may, however, last for two weeks before vanishing automatically.
The pain is most affective during the night and even the lightest of objects may feel uncomfortable or painful.
Diagnosis of Gout
The best way to detect gout is by testing the joint fluid for urate crystals. The doctor may take out a little fluid from the joints and examine under a microscope for the signs of urate crystals. The crystals are usually formed in the cartilages of the bones, which are especially found in the joints. The presence of urate crystals may signify the presence of gouty arthritis.
The doctors may also perform a blood test to check the presence of uric acid in the blood stream. However, many believe the blood tests to be misleading. Sometimes, there are no signs of gout present but the blood may have unusual amounts of uric acid. On the other hand, sometimes, a person may have gout but the uric acid levels in the blood may be normal.
Causes of Gout
The predominant cause of gout is accumulation of the urate crystals around the cartilages of the bones. This results in excruciatingly painful, red swellings around the joints of the bones. The crystals of uric acid may form when there is a highly elevated level of uric acid in the blood. Uric acids are produced due to the breakdown of the purines, a substance naturally found in the body. Some foods, such as organ meats, anchovies, herring, asparagus and mushrooms may also contain or increase the levels of uric acid in the blood.
Normally, the blood carries the uric acid to the kidneys where it is passed on to the urine. Sometimes, due to an abnormality, the production of uric acid may be excessive or the kidney may fail to pass on the uric acid to urine. Whatever the reason may be the excessive amounts of uric acid or the presence of urate crystals cause arthritis of the joints, or gouts. Due to the excess amount of uric acid, sharp, needle like urate crystals may form around the cartilages of the bones.
Types of Gout
Primary gout: Primary gout is a disorder that occurs due to high deposits of urate crystals around the cartilages of the bones. It is found that the high levels of uric acid in the blood are caused mainly by protein rich foods. Obese people are also more susceptible to gout than the people with normal weight. Higher intake of alcohol may also result in increase of urate crystals.
Secondary gout: Secondary gout is a manifestation of other chronic illnesses. Gout can be a result of the medical conditions, including combination of obesity and hyperuricemia and leukemia. Some other medical conditions, such as diabetes, polycythaemia, intake of cytotoxics, obesity, hypertension, renal disorders and hemolytic anemia.
Treatment of Gout
Treatment of gout is generally performed with the help of the medications. The medicines that are used for the treatment include Nonsteroidal drugs, cochicine and steroids.
The non steroidal anti inflammatory drugs are used to soothe the inflammations and for managing pain. The NSAIDs may include over the counter medicines, such as ibuprofen (Advil, Motrin) and naproxen (Aleve) etc. Sometimes, powerful medications may also be advised. The NSAIDs are primarily disadvantageous due to their side effects, such as stomach pain, bleeding and ulcers.
Colchicine is a powerful alternative to NSAIDs but can have serious side effects, such as nausea, vomiting and diarrhea.
Steroids may be prescribed to control the inflammation and pain. However, there are serious side effects associated with the steroids, such as poor wound healing, thinning bones and a decreased ability to fight infections. The most common steroid is the drug prednisone. Steroids are usually administered in pill form. Sometimes, injections into the joints may also be used.
Living with Gout
The first and foremost step the people with gout should take is to decrease the amount of animal protein in the diet. Usually no more than 5-6 ounces of meat, poultry or fish should be taken by the gout patients. It is believed that high protein diets increase the level of uric acid in the blood. Moreover, the foods rich in purines, such as organ meats (liver, kidney, brains, and sweetbreads), herring, anchovies, and mackerel should also be avoided to stay out of reach of gout.
Drinking alcohol is also harmful for the gout patients. It is found that alcohol inhibits the excretory process of uric acid of the blood. This results in a high level and therefore higher deposits of urate crystals around the cartilages.
Taking plenty of liquids is also quite helpful in dissolving the uric acid of the blood. Gout patients should drink as much liquid as possible to get rid of serious conditions of the disease.
Prevention of Gout
If an individual suffers from serious gout attacks, both qualitatively or quantitatively, the doctors may provide medications. There are two types of medications that are usually prescribed, namely the medications which stop uric acid production and the ones that improve uric acid removal from the body. The former type includes medications, such as Allopurinol (Zyloprim, Aloprim). These limit the uric acid production in the body and thereby reduce the accumulation of crystals around the cartilages. The latter type usually improves the kidney’s ability to remove the uric acid level, thereby maintaining an effective excretory process and less chances of accumulation of the crystals.
Some people believe that maintaining a specific routine the chances of acute gout attacks may be reduced. An ideal gout diet would include;
• Decreased amount of the red meat and seafood you eat.
• Increase in the complex carbohydrates, such as whole-grain breads.
• Abstaining from alcoholic beverages.
• Increase in the low-fat dairy products.
Read also
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Very good article, complete and concise. I would add that gout is not always caused by our diet but can be caused by physical diseases as well primarily kidney. This seems to show up later in life most noticeable in our seniors.