Gout
Gout is a form of inflammatory arthritis that causes pain and swelling with redness in your joints. Gout happens when there is a buildup of uric acid in your body.
Gout most commonly affects your big toe joint. But, it can affect other joints, including your knees, ankles, feet, hands and wrists.
Gout symptoms come and go (recur) in episodes called flares or gout attacks.
Causes of gout
- A buildup of excess uric acid in your body causes gout.
- Your body naturally makes uric acid when it breaks down chemicals called purines found in certain foods and drinks.
- Your kidneys usually filter uric acid out of your blood. Sometimes your body makes too much uric acid, or your kidneys do not remove it from your blood fast enough.
Having temporarily high uric acid levels does not mean you will definitely develop gout. Many people with hyperuricemia never get gout.
Risk factors
- Overweight or obesity.
- Congestive heart failure.
- Diabetes.
- Hypertension.
- Kidney disease.
- Dietary factors.
- Medications altering urate balance.
Food causes gout
- Sugary drinks and sweets.
- High fructose corn syrup: Packaged food products and processed snacks can contain lots of high fructose corn syrup.
- Vegetables: asparagus, spinach, cauliflower, green peas, and mushrooms.
- Organ meats: These include liver, tripe, sweetbreads, brains, and kidneys.
- Game meats: Specialties such as goose, veal, and venison all contain high levels of purines.
- Certain seafood: shrimp, mussels, oysters, lobster, scallops, codfish, tuna, trout, and haddock.
- Red meat: beef, lamb, and bacon.
- Turkey: Especially processed deli turkey.
- Gravy and meat sauces.
Complications of gout
- Tophi: They are masses of uric acid crystals that form under the skin.
- Kidney complications: like kidney stones and chronic urinary nephropathy.
What else should I know?
If you have excess body weight and gout, losing weight can help with symptoms.
Drinking plenty of water can also help.
Diagnostic tests for gout
- Your doctor can take a sample of fluid from your inflamed joint that is in pain, and if the test showed uric acid crystals, then you have gout, and this is the best test for diagnosis.
- Sometimes the doctor does not need a sample if you have typical symptoms like pain and swelling of the big toe or your symptoms completely go away between flares.
Gout treatment
- NSAID: a large group of painkillers with anti-inflammatory effects, like ibuprofen and diclofenac.
- Colchicine: It helps with gout, but it can cause diarrhea, nausea, and stomach pain.
- Steroids: it reduces the swelling and pain. It is not the first choice for doctors unless there is a minimal response to previous medications or there are contraindications.
Medicines to prevent gout flares
There are medications that reduce uric acid levels and then reduce the chances of having future gout flares. For example: allopurinol, febuxostat, and probenecid.
People with severe gout can get a medication called pegloticase.
Regular follow-up
Your doctor will order blood tests to check uric acid regularly. This is to make sure that the medicine is working and you are taking the right dose and reaching the target uric acid.
