What is Gout? What are the symptoms and treatment methods?
Gout, also known as the disease of kings in history, is an arthritis, or joint disease, characterized by an increase in uric acid circulating in the blood. The symptoms of gout develop due to uric acid crystals accumulating in the joints and the body’s reaction to them. Gout attacks usually occur at night without any warning symptoms. Many gout patients recover by paying attention to diet and lifestyle, but some patients require medical treatment.
What is Gout?
Gout is a common arthritis, a type of joint inflammation, that can affect anyone. Although it is considered among rheumatic diseases, it can also be defined as a metabolic disease. This disease, which is characterized by sudden, severely painful swelling, redness and tension in the joints, most commonly affects the big toe joint. Attacks usually occur at night when the thumb burns as if it had been set on fire, waking the person from sleep. The affected joint is hot, edematous, and so tense that it cannot even tolerate the weight of the bed sheet. Symptoms of gout may sometimes disappear and reappear. After recurrent gout attacks, uric acid crystals may accumulate permanently in that joint, forming swellings called “tophus” that distort the shape of the joint.
What Causes Gout?
Gout disease occurs due to the accumulation of uric acid crystals in the joints and the inflammation developed by the body against the accumulated urate crystals. These accumulated uric acid crystals cause serious pain in the joints. Uric acid crystals develop when the amount of uric acid circulating in the blood increases. Uric acid is an end product resulting from the metabolism of purine-containing substances naturally found in the body. Purines are also found in high amounts in meat and meat products and seafood. In addition, it is known that alcoholic beverages, especially beer, and fructose-sweetened beverages increase uric acid levels in the body.
Normally, uric acid is dissolved in the blood and excreted through the kidneys in the urine. However, in some cases, either the body produces too much uric acid or the excretion of uric acid from the kidneys decreases. In this case, uric acid that accumulates in the blood develops uric acid crystals with sharp, needle-like protrusions, and these crystals accumulate in the joints or surrounding tissues, causing pain, inflammation and swelling.
What are the Risk Factors for Gout?
The risk of developing gout increases when uric acid levels in the body are high. Factors that increase the amount of uric acid can be listed as follows.
- Diet: Eating too much meat and meat products and drinking sugary drinks sweetened with fructose increase uric acid levels in the blood. It has been reported that consumption of alcoholic beverages, especially beer, increases uric acid production.
- Obesity: Overweight individuals have increased uric acid production and decreased uric acid excretion from the kidneys.
- Chronic diseases: Some diseases increase the risk of gout. The risk of gout increases in chronic diseases such as uncontrolled high blood pressure, diabetes, metabolic syndrome, heart and kidney diseases.
- Medicines: Thiazide diuretics used in the treatment of hypertension, low-dose aspirin, and immunosuppressive drugs used in organ transplant patients may cause an increase in uric acid in the blood.
- Family history: The risk of developing gout in individuals with first- and second-degree relatives with gout is higher than other individuals.
- Age and Gender: Gout usually occurs in men. Lower uric acid levels in the blood are detected in women. However, after menopause, uric acid levels in women reach the same level as in men. In addition, gout occurs earlier in men (usually between the ages of 30 and 50, while in women, gout begins to occur after menopause).
- Previous trauma or surgery: The risk of having a gout attack increases in people who have recently undergone trauma or surgery.
What are the symptoms of gout disease?
Gout symptoms usually appear suddenly and at night.
- severe joint pain
Gout usually affects the big toe joint, but it can affect all other joints. Other frequently affected joints are; ankles, elbows, wrists and fingers. Pain is usually most severe in the first 12 hours of the attack.
- Persistent joint discomfort
After the first severe pain attack passes, discomfort in the joints continues for a few days to a few weeks. Recurrent attacks last longer and involve more joints.
- Inflammation and redness
Swelling, tightness and intense redness are observed in the affected joint due to inflammation.
- limitation of movement
As gout progresses, the mobility of the joint decreases and patients begin to have difficulty using their joints.
How to Diet for Gout?
The answer to the question of how to deal with gout lies in a proper diet. In gout, it is possible to prevent the development of attacks with diet and to reduce the severity of the attack when it occurs. Features to consider in the diet are:
- Drinking plenty of fluids, especially water, and staying away from fructose-sweetened beverages.
- Meeting protein needs from low-fat milk and dairy products.
- Limiting consumption of meat, fish and poultry. Consuming it in small amounts can be tolerated by gout sufferers. In addition, determining which of the listed sources is more harmful to the person is of great importance in nutrition.
- Preventing weight gain and losing weight by consuming small portions. The important point here is the need to avoid rapid and excessive weight loss as it will suddenly increase the uric acid level.
Gout Disease Diagnosis and Treatment
The diagnosis of gout is usually made as a result of the patient’s medical history, nutritional habits, medications used, and physical examination findings. However, high levels of uric acid and inflammation indicators in the blood help in diagnosis. Rarely, in patients with gout disease, uric acid levels may be found normal in blood tests. It should also be taken into consideration that there may be patients who do not develop gout despite having high uric acid levels in their blood tests. Radiological methods can also be used to show the findings in the joint with gout disease. Although it is not used very frequently, if necessary, the diagnosis can be made by taking a sample of the fluid accumulated in the joint with a needle by a specialist physician and seeing uric acid crystals under the microscope. Uric acid crystals can accumulate outside the joints and especially in the kidneys, causing the formation of uric acid stones and deterioration of kidney functions in the future.
During acute, new-onset attacks, treatments containing painkillers, anti-inflammatory drugs, and sometimes corticosteroids can be used. Additionally, to prevent new attacks, medications that reduce uric acid formation and increase uric acid excretion in urine are used after the acute period has passed.
More important than medications, it is necessary to be meticulous about preventing the development of gout attacks, regulating the person’s diet to prevent the uric acid level from increasing, staying hydrated, losing excess weight, and not using shoes that squeeze the toes.
If you think you have gout or are looking for treatment methods for your gout, do not forget to contact a specialist.