Gout
What is Gout ?
Gout is a common and complex form of arthritis that can affect anyone. It’s characterized by sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints, most often in the big toe.
An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen, and so tender that even the weight of the bedsheet on it may seem intolerable. Gout symptoms may come and go, but there are ways to manage symptoms and prevent flares.
Symptoms
- Intense joint pain
- Lingering discomfort
- Inflammation and redness
- Limited range of motion
- Discoloration
- Stiffness
- Swelling
- Tenderness
- Warmth
- Joint damage
Cause
Gout occurs when urate crystals accumulate in your joints, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines — substances that are found naturally in your body. Purines are also found in certain foods, including red meat and organ meats, such as liver. Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout, and tuna. Alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose) promote higher levels of uric acid. Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes either your body produces too much uric acid or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needlelike urate crystals in a joint or surrounding tissue that cause pain, inflammation, and swelling.
Risk Factors
You’re more likely to develop gout if you have high levels of uric acid in your body. Factors that increase the uric acid level in your body include: Diet. Eating a diet rich in red meat and shellfish and drinking beverages sweetened with fruit sugar (fructose) increases levels of uric acid, which increases your risk of gout. Alcohol consumption, especially of beer, also increases the risk of gout. Weight. If you’re overweight, your body produces more uric acid, and your kidneys have a more difficult time eliminating uric acid. Medical conditions. Certain diseases and conditions increase your risk of gout. These include untreated high blood pressure and chronic conditions such as diabetes, obesity, metabolic syndrome, and heart and kidney diseases. Certain medications. Low-dose aspirin and some medications used to control hypertension — including thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and beta blockers — also can increase uric acid levels. So, can the use of anti-rejection drugs be prescribed for people who have undergone an organ transplant. Family history of gout. If other members of your family have had gout, you’re more likely to develop the disease. Age and sex. Gout occurs more often in men, primarily because women tend to have lower uric acid levels. After menopause, however, women’s uric acid levels approach those of men. Men are also more likely to develop gout earlier, usually between the ages of 30 and 50 — whereas women generally develop signs and symptoms after menopause. Recent surgery or trauma. Experiencing recent surgery or trauma can sometimes trigger a gout attack. In some people, receiving a vaccination can trigger a gout flare.
When to see a Doctor
If you experience sudden, intense pain in a joint, call your doctor. Gout that goes untreated can lead to worsening pain and joint damage. Seek medical care immediately if you have a fever and a joint is hot and inflamed, which can be a sign of infection.