Gout is a common form of arthritis that’s characterized by severe pain, swelling, and redness in one or more joints, although most often felt in the big toe. It is more commonly reported in men, between the ages 30-50, while in women after the age of menopause. The pain is usually severe enough to disrupt normal daily activities, and even at night preventing sleep, or waking the person from sleep at night.
The symptoms of Gout occur almost suddenly, and as touched above usually occur at night. They present as:
Intense joint pain: This affects the big toe most commonly, and is usually described as if the toe is “on fire”. It affects other joints like those of the ankles, knees, wrists, and fingers and is very severe.
Inflammation and Redness: The affected area becomes swollen, red, and warm to the touch.
Limited range of motion. The inflammation eventually results in a temporary loss of function of the affected area.
So, about the risk factors of Gout, this usually results from an accumulation of uric acid in the blood, which then forms crystals and eventual inflammation leading to the intense pain of gout. Uric acid is gotten from the breakdown of purines, a substance naturally found in the body, and also present in certain foods like red meat, seafood, and also alcohol-containing beverages like beer.
This imbalance (leading to the accumulation) is due to the inability of the kidney to clear the excess uric acid formed, or due to the body producing larger amounts than the kidney can clear normally.
Risk factors or habits that predispose to a person having excess uric acid levels include:
Diet: Red meat, shellfish, and other seafood, and beverages (fruit sugar).
Alcohol: In excess
Weight: Due to the production of more uric acid than the kidneys can afford to clear, hence leading to an accumulation.
Existing Medical Conditions: Hypertension, Diabetes, Heart and Kidney diseases
Use of Certain Medications: Aspirin, antihypertensives like hydrochlorothiazide, Lisinopril, and propranolol.
Family History of Gout: Gouty conditions tend to run in the family.
The diagnosis of Gout can be tricky at times because its signs and symptoms mimic other causes of arthritis, and also because not everyone with high levels of uric acid comes down with gout. However, a diagnostic test done to confirm gout is the joint fluid test, where fluid is extracted from the affected joint with a needle. The fluid is then examined to see if any uric acid crystals are present. Also, the fluid is analyzed for bacteria, to rule out a joint infection.
Imaging tests like ultrasound are equally done to rule out other causes of inflammation.
After the diagnosis of gout is established, treatment is medications to treat both acute current flares and also prevent recurrence and complications.
Non-Steroidal Anti Inflammatory agents (NSAIDs) like Ibuprofen, Naproxen, or Celecoxib.
Colchicine: An anti-inflammatory that reduces gout pain.
Corticosteroids: Prednisolone and other steroids can also be prescribed to reduce joint pain and inflammation.
Allopurinol: This is used to prevent a recurrence, and it acts to reduce uric acid production. It should also be used mainly on a doctor’s prescription and not gotten over-the-counter.
Gout can be prevented and the best technique is via lifestyle and dietary modifications.
Maintaining adequate fluid intake helps prevent acute gout attacks and decreases the risk of kidney stone formation in people with gout.
Then, the intake of alcohol should be minimized as excess alcohol can precipitate uric acid crystals in the bloodstream.
Dietary changes as well can help reduce uric acid levels in the blood. As purine and purine-containing substances are converted by the body into uric acid, purine-rich foods should be avoided, including shellfish organ meats, such as liver and kidneys.
Also, weight reduction is very helpful in lowering the risk of recurrent attacks of gout.
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