Gout is an ancient disease, known to have been around for centuries as it was well described by Hippocrates in the 5th century BC. Gout is one of the commonest forms of arthritis and the reason people come to hospitals with acute attacks. Despite gout medication is easily found at local pharmacies, the incidence of gout hasn’t shown a decline in its trend, and this calls for an analysis of what causes gout and what can be done to prevent from getting it.
The signs and symptoms of gout most often occur suddenly, and more often so at night. They are:
Joint pain of gout acute attacks can be intense and debilitating. It occurs most frequently, but not exclusively at the joint of the big toe. Gout can also involve the ankles, knees, elbows, wrist and even the fingers.
After the severe initial pain has subsided, some residual joint discomfort may last ranging from a few days up to a few weeks. Subsequent attacks may last longer and affect more joints.
The affected joint may exhibit all the signs of inflammation. The joint will be warm, swollen, red, and have tenderness to touch.
Restriction of movement
When the joint swells up too much, and the pain is excruciating, there will be marked limitation to the movement of the joint.
Presence of nodules
After recurrent attacks, nodules called tophi could form in the skin at commonly found sites such as the fingers, elbows, knees, and ear lobes.
Gout is a manifestation of crystal deposition in the joints. These crystals are called urate crystals because they are formed from excessive uric acid in the blood. These crystals deposited in the joints will initiate an inflammatory response and intense pain of a typical gout attack.
Uric acid is a naturally found substance in the blood and it is produced from the breakdown of purines, which is also a substance naturally found in the body. Purines can also be found in higher concentrations in certain foods such as red meat which comprises beef, duck, certain seafood such as mussels, scallops, tuna, anchovies and sardines and vegetables like beans, spinach and asparagus. Organs too have a high concentration of purines such as the liver and kidney. Therefore, avoiding these foods can reduce the occurrence of gout acute attacks.
Although these foods have high purine content, avoiding it completely can only bring down serum uric acid by 15-20%. Hence dietary restriction must be aided by the help of medications to obtain adequate control of blood uric acid levels.
This is especially true due to the multifactorial nature of the disease. Some recognizable risk factors include:
There will be an overproduction of uric acid by the body and the kidneys will have difficulty in eliminating them.
Certain medical conditions
Some chronic conditions can increase the chances of developing gouts such as hypertension and diabetes.
Some medications used to treat hypertension such as thiazide diuretics, and low dose-aspirin are known to increase uric acid levels.
Family history of gout
If your immediate family members have gout, then chances of you developing gout will be much higher.
Age and Sex
The distribution skewed to the men because men tend to have higher uric acid levels compared to women. Men develop gout earlier around the age of 30-50 years, whereas women develop gout later after menopause.
Recent surgery or trauma
History of recent surgery and trauma has been documented to increase the chances of developing a gout attack.