Gout
Gout is basically a complex type of arthritis and it can affect anybody. This is indicated by tenderness, joint pain, redness of the affected joint, swelling, etc. A common joint affected by gout is the great toe.
Gout can affect you suddenly, it can disrupt your sleep at midnight with a burning sensation in your big toe. The affected part becomes warm and tender with swelling. Symptoms of gout are not sustained, sometimes you feel severe pain and sometimes there is just mild pain.
Symptoms
- Severe joint pain: Gout commonly affects the first metatarsal joint or big toe but also affects other joints like the elbow, wrist, fingers, ankle, and knees. you experience severe pain in the first 4 hours to 12 hours after it starts.
- Discomfort: When the pain subsides, the Patient feels some discomfort or altered sensation that lasts for days or weeks.
- Inflammation: The joints which are affected by gout become warm, tender, and swollen.
- Restricted movement: people also experience restricted joint activity.
Causes
- Uric acid accumulation: Gout mainly caused due to urate crystals accumulation in joints, These crystals forms when uric acid is high in your blood and it causes joint pain. Uric acid produced due to the breakdown of purines (Purines are substances naturally found in the body, and also found in food like seafood, meat, etc.)
Uric acid always dissolves in blood and passes to the kidneys then removes through the urine. But sometimes either body produces an excessive quantity of uric acid or the kidneys evacuate a small volume of it. This excess uric acid builds sharp pin-like crystals in joints and tissues.
Risk factors:
- Food: Eating meat and seafood, alcohol, and fruit sugar beverages.
- Obesity: There is a higher production of uric acid in people with obesity.
- Diseases: The risk of gout increases in patients having diabetes, blood pressure, or any other metabolic diseases.
- Medication: The medications for hypertension, anticoagulants, etc. cause a rise in uric acid levels.
- Family history: If there is a history of gout in your family, you are more prone to have gout in the future.
- Age and gender: Very common in males, the common age is 30 and 50. females commonly develop gout after menopause.
Complications
People who are having gout can develop other severe conditions like: –
- Repeated gout: Some people face gout attacks many times.
- Advanced gout: If untreated it can form urate crystals and form nodules called Tophi- in joints, fingers, hands, and under the skin.
- Renal stone: These urate crystals can cause kidney stones if not treated.
Prevention
- Stay hydrated
- Avoid alcohol
- Use low-fat milk product
- Avoid or limit seafood and meat.
- Watch your weight
Diagnosis
- Examination of joint fluid: Shows urate crystals under the microscope.
- Blood examination: To check the level of uric acid and creatinine levels.
- X-Ray: To see the joint condition.
- ultrasound: To detect the urate crystals.
- CT scan: To detect the urate crystals.
Treatment
If not treated, it can cause arthritis which is a very painful condition and can lead to deformity of joints.
Treatment based on the severity of the disease. Medicines are given to relieve pain and to avoid further gout attacks.
- Medications to relieve pain:
- NSAIDs – Ibuprofen, aspirin, naproxen, etc.
- colchicine
- corticosteroids
- Medications to avoid further gout:
- Allopurinol and febuxostat
- probenecid
- Along with medication, there are things which you have to take care of:
- Avoid alcohol consumption
- Control your weight
- Avoid smoking
- Gout Surgery Generally, gout is treated without surgery. But sometimes damage the joints, tendons, and can cause further infection.The urate crystals or Tophi can damage the affected joint permanently, which need surgical management like: –
- Tophi removal surgery
- Joint replacement
- Joint fusion