Gout-What You Need to Know About Your Symptoms and How to Treat It

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Gout- 8 things You Need to Know About Your Symptoms and Treatment

Introduction

What is Gout?

Gout is a form of arthritis that occurs when uric acid crystals build up in the body. It is also called the Disease of the Kings. Why? Because in the good old days when kings used to rule, they were found to be chubby (overweight or obese), eating lots of meat and drinking a lot of wine. Over a period of days, these kings would have hyperuricemia, a condition where a high amount of uric acid was produced in the body. The success uric acid then got deposited as crystals in the joints of the body (have a look below at the X- rays of different sites where they got deposited)

These crystals deposit in various joints of the body, causing sharp stabbing pains in the joints. Uric acid is a by-product of the body breaking down proteins.

When a person has impaired metabolism of proteins, particularly an amino acid that is a part of the protein, called Purine, and he or she eats a high-protein diet, their body produces more uric acid. Uric acid can also build up in the body if a person doesn’t get enough water. It’s easy for uric acid to build up if a person doesn’t drink enough water.

Another key factor is consuming alcohol along with a high protein diet. So, it’s important to limit how much alcohol they consume or to drink plenty of water to help dilute the uric acid.

Picture showing gout formation in the right foot
Gout in the right foot- designed on Canva Pro

Which are the joints most affected by Gout?

As shown in the picture above, the most common site of deposition of the uric acid crystals is at the base of the great toe. Below you can have a look at the X-ray pictures of how gout appears in various joints-

X-ray pictures of gout at different sites/joints in the body.
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Gout is quite common, affecting around 5 percent of the population in any one year. It’s most common in males between the ages of 50 and 60, with a peak incidence between the ages of 50 and 60.

What causes high Uric Acid levels in the body?

In some individuals, there’s an impairment of metabolism of an amino acid called purine, as mentioned above. Purine is present in proteins of animal origin such as meat, fish, eggs, chicken, etc. They are also present in some lentils. In some vegetables such as cabbage, broccoli, turnips, etc., the level of naturally occurring uric acid is quite high.

This is a form of arthritis that occurs when uric acid crystals build up in the body and get deposited in the joints, particularly the small joints of the foot/ feet, thereby causing sharp stabbing pains in the joints.

Uric acid is a by-product of the body breaking down proteins. When a person eats a high-protein diet, their body produces more uric acid. Uric acid can also build up in the body if a person doesn’t get enough water.

It’s easy for uric acid to build up if a person doesn’t drink enough water, so it’s important to limit how much alcohol they consume or to drink water to help dilute the uric acid.

How is Gout Diagnosed?

This disease is usually diagnosed based on a person’s symptoms and a doctor’s history-taking. The doctor will ask questions about a person’s symptoms and overall health. Urine tests can also be performed to check for the presence of uric acid.

A blood test called a Renal profile or Kidney profile can also be performed to look for signs of kidney disease. The uric acid levels rise in the blood which confirms the diagnosis. The normal range for uric acid in the blood is 2.5 to 7.00 mg/dl. Any value above 7.00mg/dl is a risk factor for getting this disease.

Other tests to consider include a urinalysis and a complete blood count. All of these tests will help doctors determine if they should order more extensive testing to look further into the cause of gout.

Treatment Overview

The treatment is based on the cause of gout. If the uric acid is coming from a diet that is high in protein, then simply making changes to the diet can help reduce the amount of uric acid in the body.

Proteins are made up of amino acids. One of the amino acids called Purine is particularly high in meat and fish. In gout, the metabolism of purine is hampered thereby giving rise to uric acid production.

Again, if this non-vegetarian diet is accompanied by alcohol, the chances of getting the disease are very high.

To treat gout caused by a diet that’s too high in protein, it’s important to limit how much alcohol a person consumes. Alcohol can increase uric acid levels in the body, so it’s important to limit how much someone drinks.

Over-the-counter medicines

Some over-the-counter medications can also help decrease uric acid levels in the body. For example, allopurinol is a cheap medication that is often given to gout patients to decrease their uric acid levels and eliminate their pain.

As we mentioned above, one of the main causes of gout is a diet that’s too high in protein. To treat this type of gout, it’s important to limit how much alcohol a person consumes. Over-the-counter medications can also be helpful in treating gout, like allopurinol, which helps decrease uric acid levels in the body.

Drugs for Prescription

For gout caused by a kidney problem, medication might be prescribed to help reduce uric acid levels in the body. For example, medications such as allopurinol help clear uric acid crystals from the body. For gout caused by joint infection, medication might be prescribed to help reduce pain and treat the infection.

Food and Supplement Recommendations

The diet should be simple, healthy, and low in purines, which are a building block in many foods and supplements [especially proteins prescribed for body building]. Foods rich in purines include: –

  • Shellfish
  • Liver,
  • Kidneys, and
  • Other organ meats – Sausages – Flank, sirloin steak, short ribs, and other fatty cuts of red meat
  • Mushrooms
  • Asparagus
  • Broccoli
  • Okra

These foods are better avoided or can be had occasionally.

Useful resources-

Mayo clinic- Gout

Conclusion

Gout is very treatable, but only if caught early. Knowing the signs and symptoms, and then treating them early will decrease the risk of long-term complications.

Drinking enough water and limiting how much alcohol is key in preventing uric acid levels from getting too high. It is important to protect joints while doing so.

It’s important to consult with a doctor to choose the best treatment plan for you.

If you have gout, your doctor can help you decide on the best treatment plan. In general, diets low in purine-rich foods and moderate in alcohol can help treat gout.