Gout, a common type of inflammatory arthritis, is characterized by sudden and severe pain attacks around the joints, mainly the big toe base. Its attack occurs suddenly; someone can wake up in the middle of the night or morning with a feeling that their big toe or other joints are on fire! The condition primarily attacks men over 30 years, and women become more prone to it after their menopause.
Causes of Gout
Gout is caused by the buildup of excess uric acid in the blood – a medical condition called hyperuricemia. The body generates this uric acid during the breakdown of purines, which are found naturally in the body. Purines are as well found in foods like steak, seafood, organ meat, and alcoholic beverages, specifically beer and sugar-sweetened drinks.
Certain conditions like obesity, dehydration, metabolism syndrome, diabetes, hypertension, and using particular medications like diuretics increase gout attack chances.
Ideally, uric acid dissolves in the blood and is later disposed of by the kidney through urine. But sometimes, the body either generates too much uric acid or the kidney excrete very little uric acid. As a result, uric acid builds up, forming sharp, needle-like crystals in the joints, fluids, or tissues around the big toe, causing its pain, swelling, and redness.
Gout Signs and Symptoms
Some people experience high uric acid levels in their blood, but no symptoms, a condition called asymptomatic gout. For severe gout conditions, inflammation in joints lasts for 3 -10 days.
Common Signs and Symptoms of Gout Include:
Acute joint pain – Gout often attacks the base of the big toe as well as other joints such as ankles, elbows, kneels, fingers and wrists. The pain is most likely to be severe in the first 4 to 12 hours after it starts.
Inflammation and redness – Affected tissues and joints become stiff, swollen, tender, red, and warm.
Lingering discomfort – Once the acute pain subsides, joint discomfort lasts from several days to a few weeks. More joints attacks will likely last longer as the condition worsens.
As gout progresses, joints become stiffer, making it difficult for them to move freely.
Gout becomes chronic if left untreated and leads to the formation of tophi – hard lumps that develop around the joints, and soft skin tissue surrounding them. These hard lumps can permanently damage the joints.
Prompt gout treatment is essential to prevent its chronic stage, which is arthritis. Treatment plans recommended by doctors depend on the gout severity or stage.
First, gout is diagnosed by assessing its symptoms from physical examinations, lab tests, to X-rays. It can only be identified when the joints are hot, painful, swollen and when tests discover high uric acid levels around the affected joints.
Gout medications work in two ways: they either relieve pain and reduce inflammation or prevent gout attacks in the future by lowering the levels of uric acid.
Effective drugs to alleviate gout pain are:
– NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin (Bufferin).
– Colchicine like colcrys and mitigare
Effective drugs to prevent future gout attacks include:
– Xanthine oxidase inhibitors like allopurinol
Along with these medications, a doctor can recommend changes in lifestyle to manage symptoms and lower risks of future attacks. For instance, the doctor might encourage someone to reduce their alcohol intake, lose weight or quit smoking.
Some foods have high purine levels, which are broken down into uric acid by the body. People with hyperuricemia conditions are advised to eat a healthy diet – avoid particular foods and drinks like red meat, organ meat, and certain seafood. Doctors also recommend staying hydrated by drinking plenty of fluids, mainly water, except high-fructose sweetened drinks.
Exercise is vital not only to lower the chances of gout attacks but also for overall health and well-being. People should stick to exercises that are easy on their joints, such as walking, swimming, and bicycling.
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