Gout is a common and complex form of arthritis characterised by swelling, stiffness and severe pain in the joints of your foot, particularly the joint at your big toe. It occurs due to an abnormal metabolism of uric acid, resulting in accumulation of uric acid in the tissues and blood. It may also result in tophi, kidney stones or urate nephropathy.
People with gout either produce too much uric acid, or more commonly, their kidneys are inadequate in removing it. Mostly characterized by sudden and severe attacks of pain, swelling, redness and tenderness in the joints.
An attack of gouty arthritis can occur suddenly, in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, inflamed and tender that even the weight of the sheet on it may seem unbearable.
Causes of gout
The crystallization of uric acid, often related to relatively high levels in the blood, is the underlying cause of gout. This can occur because of diet, genetic predisposition or under-excretion of urate, the salts of uric acid.
The body produces uric acid when it breaks down purines — chemical compounds that are found in high amounts in certain foods such as meat, poultry, and seafood.
Risk factors of gout
Factors that increase the uric acid level in your body include:
- Age. Men between 40 and 50 years old and post-menopausal women.
- Gender. Men are more likely than women.
- Family history. If you have someone in your family with gouty arthritis, you may be more likely to develop it as well.
- Diet. Eating too much purine-rich food raises your risk. Red meat, organ meat, and certain fish contain a lot of purines.
- Intake of alcoholic beverages. Especially beer, increases the risk.
- Medications. Some medications, such as diuretics and cyclosporine, can put you at risk of gouty arthritis.
- Other health conditions. High blood pressure, kidney disease, thyroid disease, sleep apnea, and diabetes can all raise your risk of gout.
Symptoms of gout
The signs and symptoms of gout include:
- Intense joint pain. Gout usually affects the large joint of your big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers.
- Hot, swollen and stiff joint.
- Inflammation and redness. The affected joint or joints become swollen, tender, warm and red.
- Limited range of motion. As gout progresses, you may not be able to move your joints normally.
Tests and diagnosis
Gout can be tricky to diagnose, as its symptoms, when they do appear, are similar to those of other conditions.
- The most important diagnostic test is joint fluid test, where fluid is extracted from the affected joint with a needle. The fluid is then examined to see if any urate crystals are present.
- Blood sample to look at cell counts, uric acid levels and kidney function.
- X-rays to assess underlying joint damage
The initial aim of treatment is to settle the symptoms of an acute attack. Repeated attacks can be prevented by medications that reduce serum uric acid levels.
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, for inflammation and pain in your joint.
- Colchicine for joint pain
- Corticosteroids, such as prednisone, also for inflammation and pain in your joint.
- Others such as allopurinol to reduce your body’s production of uric acid.
Lifestyle and home remedies
Medications are often the most effective way to treat acute gout and can prevent recurrent attacks of gout. However, making certain lifestyle changes also are important, such as:
- Limiting alcoholic beverages and drinks sweetened with fruit sugar (fructose). Instead, drink plenty of nonalcoholic beverages, especially water.
- Limiting intake of foods high in purines, such as red meat, organ meats and seafood.
- Exercising regularly and losing weight. Keeping your body at a healthy weight reduces your risk of gout.