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Dr. Krutika Surana

Gout

Updated: Feb 24, 2023




Overview


Gout is a typical and complicated kind of arthritis that can afflict anyone at any age. It is distinguished by abrupt, acute episodes of pain, swelling, redness, and tenderness in one or more joints, most often the big toe.


Gout symptoms can be severe, waking you up in the middle of the night with the sensation that your big toe is on fire. The injured joint is inflamed, swollen, and so sensitive that even the weight of the bedsheet may feel unbearable.


Symptoms

Gout symptoms typically appear quickly and frequently at night. They are

  • Joint discomfort that is excruciating. Gout often affects the big toe, however, it can affect any joint. Ankles, knees, elbows, wrists, and fingers are all often afflicted joints. The pain is most likely severe in the first four to twelve hours after it begins.

  • Persistent discomfort. Some joint soreness may remain from a few days to a few weeks after the most acute pain has subsided. Later episodes are more likely to be more severe and impact more joints.

  • Redness and inflammation The affected joint or joints swell and become painful, heated, and red.

  • The range of motion is restricted. You may be unable to move your joints generally as your gout advances.

Causes


Gout develops when urate crystals build up in your joint, producing inflammation and excruciating pain. Urate crystals can form in the presence of high amounts of uric acid in the blood. When your body breaks down purines, which are naturally occurring chemicals, it generates uric acid.


Purines can also be present in some meals, such as red meat and organ meats like liver. Anchovies, sardines, mussels, scallops, trout, and tuna are examples of purine-rich seafood. Alcoholic beverages, particularly beer, and drinks sweetened with fruit sugar (fructose) raise uric acid levels.


Uric acid usually dissolves in your blood and goes into your urine via your kidneys. However, your body might create too much uric acid or your kidneys can discharge too little. When this occurs, uric acid can accumulate, generating sharp, needlelike urate crystals in the joint or surrounding tissue, causing pain, inflammation, and edema.



Risk factors

If you have excessive uric acid levels in your body, you are more prone to develop gout. The following factors contribute to a rise in uric acid levels in your body:


  • Diet - Consuming a diet high in red meat and seafood, as well as beverages sweetened with fruit sugar (fructose), raises uric acid levels, increasing your risk of gout. Gout is also exacerbated by alcohol intake, particularly beer.

  • Weight - When you're overweight, your body creates more uric acid, and your kidneys have a harder difficulty removing it.

  • Medical problems - Gout is made more likely by several disorders and circumstances. Untreated high blood pressure and chronic disorders such as diabetes, obesity, metabolic syndrome, and heart and kidney disease are examples of these.

  • Some medicines - Low-dose aspirin and various hypertension drugs, such as thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and beta blockers, can also raise uric acid levels. Anti-rejection medicines provided for organ transplant recipients might also be harmful.

  • Gout runs in the family - You are more prone to acquire gout if other members of your family have had the condition.

  • Age and gender - Gout is more common in men because women have lower uric acid levels. However, after menopause, women's uric acid levels approach those of males. Men are also more prone to get gout at a younger age, often between the ages of 30 and 50, whereas women typically acquire symptoms after menopause.

COMPLICATIONS

  • Gout flare-ups - Some patients may never again suffer gout symptoms. Others may have gout many times a year. In those with recurrent gout, medications may help avoid gout episodes. Gout, if left untreated, can cause joint erosion and damage.

  • Gout has progressed - Untreated gout can cause urate crystal deposits under the skin to accumulate in nodules called tophi (TOE-fie). Tophi may appear in a variety of places, including your fingers, hands, feet, elbows, and the Achilles tendons down the backs of your ankles. Tophi are normally not unpleasant, although they can swell and become sore during gout bouts.

  • Stones in the kidney - Urate crystals can form in the urinary tracts of gout patients, creating kidney stones. Medications can help minimize the chances of developing kidney stones.

Treatment

over the counter pain killers
physiotherapy
hot pack
corticosteroids
medications to block uric acid production
footwear change
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