What You Need To Know About Gout

Medically reviewed by John A. Flores MD, MS January 29, 2024| Written by Godfrey M. Wesutsa

What You Need To Know About Gout

Gout is a common disease affecting most of the world's population. The condition is a form of arthritis characterized by jointpains and discomfort. Unlike arthritis, gout symptoms also include redness and swelling of the joints, excruciating pain, and warmth. 

The gout that affects the big toe begins in the metatarsophalangeal joint and is often calledpodagra. However, the condition can also affect various body regions, such as the knees, elbows, and ankles.

According to WebMD, Gout is caused byexcessive uric acid in the blood which is produced by the body, especially if someone consumes a nitrogen-rich diet. If you have excess uric acid, the kidney may fail to excrete all of it, leaving the deposit in the tendons and joints. 

Research indicates that abouteight million Americans are affected, especially men between 30 and 50 years old and women in their menopause. The primaryrisk factors for men are obesity, high blood pressure, and consumers of thiazide diuretics and related drugs. 

What Do You Need To Know If You Have Gout 

To know if you have gout, you need to observe the signs and symptoms of the sickness. Some of thesesigns and symptoms are easily distinguishable from other health-related conditions. 

A good idea is to seek professional medical advice as soon as you see any related symptoms. Your doctor will ask about your medical history, perform a physical examination, and also order laboratory tests. The clinician may also remove fluid from the joint to ascertain the existence of crystallized uric acid deposits in the joint(s).

Now, you may be wondering, what are the signs of gout. So, let’s discuss:

Signs and Symptoms

1. Pain in the joints

Although not all joint pains are associated with gout,joint pain in some body areas like the big toe, can be associated with gout. In this case, gout is almost similar to arthritis. However, gout is diagnosed as aninflammatory disorder that may affect one part of the body. Meanwhile, arthritis causes pain in all body parts.
In addition, gout inflammation is enhanced by warm compression that accelerates its severity, whereas arthritis symptoms worsen using cold compresses. 

2. Swelling and Tenderness Around the Joints

 Swelling and tenderness around the joints are reasonable indications of a gout problem. The swelling is a result of theformation of crystals that are formed as a result of the failure of the kidney to excrete all of the produced uric acid. 

In this case, the uric acid crystallizes and is deposited on the tendon and joint, causing swelling. 

Tenderness, on the other hand, is caused by the immune inflammatory response by the body when trying to eliminate the crystallized uric acid deposited in the joint region. Furthermore, inflammation sensitizes the joint area, making it tender and painful. 

3. Skin Redness on the Affected Area

 Skin redness around the affected joint is one of the significant symptoms of gout. The inflammatory response to the crystalizeduric acid deposits in the joint majorly causes the redness. In this case, the accumulation of uric acid crystals triggers an immune response that releases inflammatory substances and white blood cells, increasing blood flow around the joint and causing warmth, swelling, and redness. 

Excruciating pain and discomfort also contribute to the skin redness in the affected joint.

Since the joint is inflamed, the localized tissue around the joint develops heightened sensitivity, making it painful. Secondly, thewarmth caused by increased blood flow to the region causes reddening of the affected area.   

Gout Diagnosis and Treatment Options

Just like many diseases, gout is diagnosed based on physical andlaboratory tests and examining the medical history, especially for persistent gout. After diagnosis, the health care professional will analyzetreatment options based on the patient's condition to manage the symptoms and prevent the adverse effects. 

Most treatment options are tailored initially to reduce inflammation and pain. However, the long-term goal is to reduce the uric acid and prevent future flare-ups. 

Diagnosis

  1. Medical History and Physical Examination: The physician will request information on yourmedical history, including previous gout attacks or joint pain and swelling. 

  1. Laboratory Examination: A laboratory test is another diagnosis method that involves checking thelevel of uric acid in the blood. It’s because high uric acid levels indicate the likelihood of gout. However, not all people with high uric acid levels develop gout and it is just one factor to determine the condition. 

The laboratory test may includejoint aspiration, where a special needle is used to draw fluid from the affected joint to confirm the presence of uric acid crystals. Findingcrystalized uric acid will confirm the condition.

Treatment

Gout treatment mainly focuses onpain relief during attacks and discouraging inflammation as the cause of swelling, warmth, and redness of the affected joint region.In this case, reducing pain and inflammation calls for lowering uric acid levels, and preventingfuture attacks. 

Available treatment for acute flares includes the following: 

  1. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are a variety of drugs manufactured mainly toreduce inflammation and relieve pain due to gout. The medicines include drugs like ibuprofen, naproxen, and indomethacin.
  2. Corticosteroidsare administered eitherorally or intravenously. The health care professional prescribes them to reduce inflammation and relieve pain.
  3. Colchicine is ananti-inflammatory remedy in the management of gout flares.
  4. Uricosuric Agents like Probenecid and Lesinurad are prescribed to increasekidney activities by enhancing uric acid excretion from the body.When normal levels of uric acid are achieved then the likelihood of a gout attack is reduced.  
  5. Uricase Enzymessuch asPegloticase are introduced into the body to reverse the severity of refractory cases of gout. In this case, the enzymes work in your body by breaking down excess uric acid, thus maintaining normal uric acid levels. 
  6. Xanthine Oxidase Inhibitorssuch asAllopurinol and febuxostat lower uric acid levels in the body by working against the enzymexanthine Oxidase - an enzyme that enhances uric acid production in the body. 
  7. Rest and Elevation: The strategy is one of the components of self-management in gout treatment. When you have a Gout Flare-up, the pain and discomfort can be minimized by resting and elevating the joint to prevent swelling and allow blood circulation. 

Lifestyle Changes You Need to Make to Reduce Any Risk of a Flare-Up

Gout can be a life-altering condition, mainly because of theexcruciating pain. In addition, adverse conditions can affect a person's normal function, such aswork and mobility because of joint pain. Therefore, lifestyle changes are necessary to aid your recovery. 

Below are some of the changes you can make to speed up the recovery:

1. Dietary Changes

Avoid or reducePurine-rich food because they can increase uric acid in the body. This food includes red meat, organ meat like the liver and kidney from beef and mutton, andsome seafood. Therefore, reducing the consumption of this food means that you can reduce uric levels in the body that trigger gout attacks. 

Moderate consumption ofAlcohol and sugary beverages is another dietary change because alcohol, especially spirit, increases uric acid levels in the body. 

Similarly,sugary beverages like soda and fruit juices can cause a higher production of uric acid. Therefore, reducing the consumption of these drinks also minimizes the production of uric acid in the body, and thus decreases gout flare-ups.

Hydration is another dietary measure for managing and preventing gout. The National Academy of Medicine suggests drinking 9 cups of fluids for healthy men and women, with 1 cup equaling 8 ounces. In this regard, an adequate water supply in the body promoteseasy dilution of uric acid. Hydrating makes it easier for the kidney to excrete excess uric acid. 

2. Maintain a Healthy Weight

Obesity and overweight conditions pose a significant risk for gout attacks. If you are obese, the likelihood of excess uric acid in the body is high. Therefore, reducing weight to a healthyBody mass index (BMI) level will ensure reduced risk. 

This can be achieved if you consume a balanced diet high in fiber and adequate exercise.

3. Regular Exercise

Exercising is one of the strategies you can use to reduce the risk of gout because it helps boost metabolism and enhance the immune system. Research shows that excess body weight is caused bybody fats, which are associated with high uric acids. 

Body fats have a high content of uric acid compared to body muscles. 

4. Medication Adherence and Mindfulness

Like any other medication a physician prescribes, you must take them as prescribed. Completing doses and staying consistent in the use of medications are crucial measures to manage gout flare-ups. 

However, patients should also bemindful of their other habits, especially about prescribed medications for other medical conditions. For example, patients should seek advice regarding alternatives todiuretics (water pills) as these raise uric acid levels. 

5. Avoid Crash Dieting

Crash dieting results inrapid weight loss and can affect body metabolism, causing increased uric levels. Extreme Rapid Weight Loss causes thebreakdown of fat cells and causes fatty acid to be released into the bloodstream.Therefore, the more fatty acid in the blood, the more uric acid is produced in the body. 

Rapid body weight loss can triggerdehydration, especially with reduced water or fluid intake. 

If you are dehydrated, you reduce your kidney's function to excrete excess uric acid, causing it to accumulate in the body. 

6. Dietary Supplements

Dietary supplements support the body’s homeostasis. And so, a balance of these may help gout patients. For instance, nutritional supplements especiallycherry extract and vitamin C help lower uric acid. And so, they may be effective in managing gout.

However, you should seek your healthcare provider's direction for any changes to the diet. 

Conclusion

Gout is a condition similar to arthritis in symptoms. Still, it may affect one joint, unlike arthritis, which causes pain in multiple body parts. Accumulation ofuric acid in the body is among the factors that cause gout. The condition is characterized byexcruciating pain, swelling, and redness in the toe joint, knees, elbows, and ankles. 

Men have a higher chance of gout attack than women who mostly experience it after menopause. Diagnosis involves examining medical history, physical features, andlaboratory tests

Treatment of the condition aims to relieve pain and reduce inflammation. Treatment for flare-ups calls for strategies that lower uric acid in the body, such as usingXanthine Oxidase Inhibitors and Uricase Enzymes.

Lifestyle changes, including diet, are also crucial. One must be careful about what one consumes to reduce uric acid in the body triggered by certain foods. Secondly, exercise can help to reduce the level of uric acid accumulation.