Gout is a disease caused by the presence of excess uric acid inside the body, resulting in defective uric acid metabolism. Excess of uric acid and its salts – the urates accumulate in the blood and the joints. Gout mainly affects hands, feet – the small joints. In the long run, increased levels of uric acid in the blood will start accumulating in the connective tissues around the joints and may form spine like crystals, leading to severe gout attacks. The intense pain is a result of the infection in the affected areas and not due to the formation of these crystals. Deposits of uric acid in the tissues are referred to as ‘Tophi’ whereas the accumulation in the urinary tract acknowledged as the Kidney-stones. Statistics show that two-thirds of the early attacks of gout affect the big toe.
Gout is a disease that results from an imbalance between the production of uric acid (a break-down product of protein digestion) and the ability to excrete this substance, which is mainly a function of the kidneys. This imbalance is caused due to high amount of uric acid, increased degeneration of cells or through diet rich in purines, which are converted to uric acid in the body.
1. The hereditary predisposition to gout is stronger than for any other musculoskeletal diseases.
2. As gout seems to be more prevalent in overweight people and this disease was earlier called as ‘rich man’s disease’, so being overweight increases the risk.
3. High protein diet (mainly animal protein) leads to gout attacks as they produce more uric acid, this diet also causes stored body fat to be consumed thereby releasing more uric acid, this overload creating some worst gout attacks.
4. Gout is frequently linked with men who consume excess alcohol, and also common in people consuming more of red meat due to the possible imbalance between production of uric acid and ability to excrete the substance.
5. It is seen that, gout is more common in men (majority over 75 years) than in women. Women usually suffer from gout after menopause.
6. Research shows that more number of people are suffering from gout than ever, this attributed to drastic changes in our lifestyle.
7. High blood pressure, use of medicines which elevate uric acid levels, kidney dysfunction are also risk-factors for gout.
Sudden onset of pain in the affected joint along with inflammation, swelling, redness, and tenderness is seen in acute cases of gout. The small joints are mostly affected, especially the big toe. Ankles, knees, wrists, fingers, and elbows are also affected by gout. In some cases, there is severe pain in the affected areas that even a slight touch makes one miserable. With time, the disease affects the tendons and tissues also.
Clinical history of the patient is evaluated for frequent attacks of painful arthritis in the small joints and other joints. Joint aspiration test is used for diagnosing gout by detecting uric acid crystals in the joint fluid obtained through aspiration technique performed under topical local anesthesia. The fluid is extracted using sterile techniques from the affected joints. The fluid is now tested for the presence of infection and crystals of uric acid. A blood test which measures the quantity of uric acid level may also be useful for diagnosis.
Listed below are some preventive measures:
1. Drink plenty of water and fluids. But it should not be alcohol.
2. Follow a low purine alkaline diet, avoiding foods that are high in purine and foods that produce uric acid.
3. Some people have found cherries, raspberries or strawberries helpful. Some chemicals contained in dark berries may help reduce the inflammation and lower the uric acid.
4. Oily fish like salmon or fatty acids like flax seed, turmeric may reduce inflammation too.
5. Include a diet rich in omega-3 fatty acids, minerals, protein, as, they will improve your overall health.
6. Alcohol consumption leads to imbalance in the levels of uric acid so it is better to reduce intake or avoid altogether.
7. It is important to maintain an ideal weight. Studies have shown that overweight people carry more risk to develop gout.
8. An optimistic approach coupled with lifestyle modifications and avoiding over-use of affected joints are some preventive measures.
9. It is equally important to get yourself evaluated from time to time by your physician for early detection.
Treatment for gout
a. Anti-inflammatory drugs are prescribed to reduce the pain and inflammation along with corticosteroids.
b. Medicines which lower uric acid levels in the blood and which prevent the formation of urates in joints, kidney and tissues are also given to patients suffering from gout.
c. Over-exertion of your body beyond the point of endurance is not advised nor is an inactive lifestyle.
d. It is better to practice disease-specific exercises and have an easily digestible diet.