Gout

Musculoskeletal

Gout is a joint disease caused by an abundance of uric acid in the blood. Uric acid is a waste product that our body usually eliminates. If, however, there is decreased excretion or increased production of this metabolite it predisposes individuals to gout. Uric acid turns into a crystal form known as monosodium urate which can deposit anywhere in the body. Most often the crystals deposit in the joints which causes localized inflammation. Resultant symptoms of severe pain are experienced by the patient along with redness and swelling of the involved area. The classical site affected by gout is the big toe, but attacks can affect other joints as well.
Gout is one of the oldest forms of arthritis in recorded history. Gout has been referred to as “rich man’s disease” because of its association with eating meat – an item usually consumed by the wealthy in historical times. Both King Henry VIII of England and King Charles I of Spain are said to have been afflicted by gouty arthritis.

Related Discussions

Related Articles

Symptoms

Gout is characterized by symptoms of pain that start suddenly and eventually diminish, even in the absence of treatment. Between the flares of pain, the affected joint will be symptom-free. The affected joint space and the tissues surrounding it are swollen, red, and feel warm to the touch. A variety of symptoms can result depending on where in the body the monosodium urate crystals settle. A collection of crystals can form a mass known as a tophus and deposit in soft tissue including that of the skin where it feels like a fixed bump. Similarly, this can happen in cartilage and frequently involves the ear. High levels of uric acid can also put individuals at risk of forming kidney stones in which case the patient would present with bouts of severe abdominal pain.

Risk Factors

  • Chronic kidney disease
  • Congestive heart failure
  • Diabetes
  • Hemolytic anemia
  • Hypertension
  • Hypothyroidism
  • Lymphoma
  • Psoriasis
  • Psoriatic arthritis

Diagnosis

To help reach a conclusive diagnosis of gout, arthrocentesis is performed. This procedure involves the aspiration of fluid from the joint space. This fluid is then tested to determine the amount of different white blood cells it has. The sample is also examined under a microscope using a polarized light, which aids in visualization of the characteristic needle-shaped crystals present in gout.

Treatments

This entails therapy aimed at relieving symptoms of a sudden attack as well as the necessary steps for avoiding future episodes. For patients experiencing acute symptoms, treatment includes the utilization of drugs that counteract the ongoing inflammatory process (e.g., indomethacin and ibuprofen). In individuals who cannot tolerate these drugs, colchicine or glucocorticoids may be given. Long-term preventative therapy is started after the initial attack subsides and is based on lowering the levels of uric acid in the body. This goal is achieved by drugs such as allopurinol, which inhibit a specific enzyme involved in the formation of uric acid.

Alternative Treatments and Home Remedies

Always consult your healthcare provider about any alternative treatment or supplement you plan on taking before you move ahead. Some alternative approaches to gout treatment include:

Dietary modification. If you closely modify your diet to lower uric acid levels, you may experience symptom relief. Eliminate alcohol, drink water abundantly, limit meat consumption, and eat complex carbohydrates. Avoid high-purine foods completely. Foods rich in antioxidants can help modulate uric acid levels. These include blueberries, blackberries, raspberries, grapes, and cherries.

Vitamin C. May lower uric acid levels in moderate amounts. Excessive vitamin C can cause hyperuricemia.

Herbs. Devil’s claw, bromelain, and turmeric may help reduce inflammation and relieve swelling and pain.

Hot and cold compresses. Use a hot compress for at least three minutes followed by a cold compress for 30 seconds to reduce swelling and pain during a flare-up. 

Acupuncture. A form of traditional Chinese medicine that uses needles on specific points on the body that may help alleviate pain associated with a gout attack.

Prevention

Lifestyle modifications to help lower the uric acid level in the blood are highly recommended to prevent future flare-ups. Food and drink items rich in purines (e.g., meat, alcohol, and anything with high fructose corn syrup) should be consumed in limited quantities because the metabolism of these products leads to the production of uric acid. Reduction of weight in overweight patients has helped with the improvement of symptoms.

References

Centers for Disease Control and Prevention. Arthritis: Gout. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/arthritis/basics/gout.html

Eustice, C. (2019, July 17). Causes and risk factors of gout: How diet, alcohol, and obesity contribute to your risk. Retrieved from Verywellhealth: https://www.verywellhealth.com/gout-risk-factors-189835

Healthline Editorial Team. (2018, September 03). Gout treatment and prevention. Retrieved from Healthline: https://www.healthline.com/health/gout-treatments

Iftikhar, N. (2018, April 19). Avoid your gout triggers to avoid sudden flare-ups. Retrieved from Healthline: https://www.healthline.com/health/gout-triggers#takeaway 

Mayo Clinic Staff. (2021, March 06). Gout. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2020, February). Gout. Retrieved from National Institute of Arthritis and Musculoskeletal and Skin Diseases: https://www.niams.nih.gov/health-topics/gout

Watson, S. (2020, September 18). Everything you need to know about gout. Retrieved from Healthline: https://www.healthline.com/health/gout

Menu

Become a Member

Join Now

Already a member?
Sign in

Or continue without becoming a member
(certain features and use of this site will be limited)

To use the Aepios.com website you acknowledge that you have read, understood, and accept the:

Disagree