Diet and Nutrition

Gout Complications

Gout Complications

Key Takeaways

  • Gout can lead to several complications.
  • Tophi are usually not painful but can be during a gout attack.
  • Excess accumulation of uric acid in the human body can lead to kidney stones and kidney disease. 

Any medical problem left untreated can have devastating consequences. With gout, most people affected may experience a single gout attack that comes with severe pain in the affected joint. Soon thereafter, the symptoms may go away for weeks and even months, and the individual may forget about seeking medical attention. This can be very dangerous because the condition may still be developing under the surface, waiting to resurface with severe complications.

This interval after the first gout attack is the time to take corrective action by way of medication and lifestyle changes to eliminate the chances of a subsequent attack.

Recurrent Gout Attacks

Ignoring the initial episode of gout can have serious implications. Over time, the gout attacks become frequent, more severe, and prolonged. The pain becomes unbearable and refuses to subside. The gout may transform into a polyarticular infection. In simpler words, this means it starts affecting more than one joint in the same limb. It may even spread to the upper extremities.

Tophi

Monosodium urate crystals are deposited in the joints of an affected individual causing intense pain. In untreated individuals, these crystals start accumulating under the skin outside the joint. These clusters are visible as small disfiguring protrusions under the skin. These white or yellowish lumps are called tophi. 

As tophi continue to grow, they begin affecting the surrounding skin and eventually reach the tissue of the joint, causing damage to it. If they become large enough, they may erupt from the skin, secreting a toothpaste-like white substance. 

Tophi are usually not painful but can be during a gout attack. Besides the big toe where gout attacks are common, tophi can also be found on the feet, ankles, knees, elbows, wrists and even ears. In fact, they can appear anywhere in the body, including your spine and vocal cords. They are a visible sign that the uric acid levels in your body need to be controlled immediately.

Joint Damage

Besides tophi, the uric acid crystals within the joint can begin to scratch against the cartilage of the bones. If not attended to, the continuous scratching can cause permanent damage to the joint. The bones may become deformed as they erode. This can lead to difficulty in movement and eventually, incapacitation of the affected limb. Joints damaged in this manner may require specialized treatment and even surgery to restore mobility.

Kidney Stones and Disease

Since the kidney is responsible for removing uric acid crystals from the blood, the organ may also be affected. High levels of uric acid can collect in the kidney, leading to the formation of stones that are extremely painful. The risk of having kidney stones therefore increases if you are suffering from gout. Uric acid stones in the kidney cannot be spotted easily with an x-ray, making diagnosis difficult. Since it may take some time before they are detected, they increase in size. Larger stones can cause permanent damage to the kidney tissue. Problems begin when the stones descend to the ureter and start interfering with the flow of urine, causing intense pain when one urinates. Stones interfere with the normal functioning of the kidney, leading to infections.

As the concentration of uric acid keeps rising when the kidney is impaired, further damage can eventually lead to kidney failure.

Heart Diseases

Several studies have concluded that gout increases the risk of cardiovascular diseases. High levels of uric acid in the body that cause gout also increase the chances of stroke, high blood pressure, and coronary diseases. Gout increases the levels of unhealthy cholesterol and lipids in the body, which start accumulating in the arteries and form blockages.

Other Complications

  • Cataract  A cloudy or opaque film forms over the lens of the eye, impairing the eye's vision. Males above sixty are at greater risk for developing a cataract as a complication of gout.
  • Dry eye syndrome – The tear ducts fail to produce the adequate amount of tears resulting in swollen, irritated red eyes.
  • Uric acid deposits in the lung – This may happen in rare cases. 

Effects on Lifestyle 

Besides the biological complications, living with untreated gout begins to affect the gout sufferer's life in various ways:

  • Sleep interruptions: Gout attacks are often experienced at night while the individual is at rest, and given the severity of the pain, it can be difficult for him or her to go back to sleep even if the attack subsides. If this continues long enough, it can lead to fatigue and stress and even mood swings. 
  • Disability: With continued damage to the joint, it becomes increasingly difficult to move the joint. This will eventually interfere with the person's regular activities since he or she can’t get around and do what they used to do.

Psychological Consequences

The disfiguring lumps that develop in chronic cases of gout can affect the appearance of a person. Tophi, as discussed earlier, can appear in any part of the body. In the long run, they may start distorting the self-image of the individual.

Nobody likes the feeling of being sick, but gout brings along with it severe pain during attacks, which are entirely unpredictable. This feeling can take a toll on the gout victim's mind, leaving him susceptible to emotional outbursts. Difficulty in movement or immobility in extreme cases adds to his professional and personal woes. Lack of adequate sleep can also contribute to mood disturbances.

As with all chronic diseases, as they eat away at one's reserves of patience, the afflicted person's relationships begin to suffer. The anxiety over the disease and the changes it brings about in one's life may lead to depression. The overall situation may appear grim to the individual when he feels that life as he has known it is slipping through his fingers.

Early diagnosis and treatment of gout are, therefore, essential in order to avoid its complications. Any negligence in taking medication or observing dietary controls can have serious consequences on the gout sufferer's physical and mental health. To most effectively deal with gout, stringently following all precautions and prescriptions under the strict guidance of one's doctor is of utmost importance.