Arthritis is an umbrella term used for any joint disease in the human body. There are close to two hundred types of diseases that affect the bones and the tissues around the joints. This is one of the reasons why your doctor may run several tests before effectively diagnosing gout.
Gout is another form of arthritis that can affect the joints in the body, usually the big toe. It causes pain, swelling, and stiffness of the affected joints that come on suddenly and can be quite severe. These attacks of pain are recurrent and may persist unless the problem is addressed. This is one of the reasons why you need to seek out immediate medical treatment so that you can get the debilitating pain alleviated with effective treatment.
What causes gout?
Gout is caused by sharp, needle-like crystals of uric acid deposited within the joints over a period of time. The pain is usually episodic in nature and subsides within a few days. However, the process may have been building up long before the pain and swelling become externally visible. Gout happens when there is a very high level of uric acid in the blood that fails to be excreted by the kidneys, and instead, accumulates in the blood. This causes the uric acid to crystallize in the joints, causing them to get inflamed, which results in extreme pain. On consulting your doctor, you may realize that you need to make a few changes to your lifestyle and diet in order for your treatment to be effective.
Uric acid is a natural waste product of the breakdown of purines, which are substances found in organ meat such as the liver, and other foods like beans, mackerel, and mushrooms. The normal range for uric acid in blood plasma is around 3.4-7.2 mg/dL in men and 2.4-6.1 mg/dL in women. The levels of uric acid in the body can be determined through blood or urine tests.
Even though uric acid may be a natural by-product, too much of it can have adverse effects. The elevated levels of uric acid in the body can be attributed to a number of factors including certain food items. The digestion of purine-rich foods, for example, produces an abnormally high amount of uric acid, which may be difficult to remove from the bloodstream. Purines are naturally found in seafood, especially sardines, salmon, and herring; offal (organ meat such as the liver and kidney), as well as mushrooms and asparagus. However, in other individuals, high levels of uric acid may be the result of medical conditions such as the overproduction of uric acid or the inability of the kidneys to process uric acid efficiently.
For this reason, you may want to avoid certain food items that contain high amounts of purines such as red meat and organ meat. However, the issue is that some of these food items also provide the essential nutrients and vitamins needed by the body. What you can do is to cut down on the food items loaded with purines and opt for healthier alternatives such as asparagus, cauliflower, spinach, and lentils.
As the levels of uric acid keep building in the bloodstream, the kidney is unable to handle all of it, leaving more of the uric acid in the bloodstream. As blood passes over the joints, where temperatures are lower compared to the rest of the body, uric acid crystallizes and is deposited within the joints. These crystals eventually become huge enough to scratch the cartilage and tendons within the joints, causing them to be irritated and swollen. If the crystals remain in the joints for long, they keep damaging the joints and may eventually lead to more serious forms of arthritis.
Who is at risk of getting gout?
Typically, men are usually diagnosed with gout compared to women, although menopausal women can be at risk, too. Generally, gout affects people above the age of 60. Besides gender and age, the triggers that exacerbate the development of gout can be put into two broad categories:
1) Medical concerns:
- Kidney problems – The kidneys are responsible for the removal of uric acid from the body, and any kidney problems can hinder this process. A normally functioning kidney excretes excess amounts of uric acid along with urine. An infection or any other problem in the kidney may interfere with this process resulting in the abnormal accumulation of uric acid in the bloodstream. Malfunctioning of the kidney may be triggered by a prolonged or severe illness.
- Joint injury – Any injury to the joints may contribute to gout pain. So if you have suffered from any joint injury, then it is bound to exacerbate your gout symptoms and may even cause you to experience heightened pain and discomfort.
- Diuretic medications – Individuals taking diuretic medications to help manage blood pressure levels or heart disease are at an increased risk of developing gout. Diuretics are basically "water pills" that remove excess water from the bloodstream but may increase the concentration of uric acid. If an individual develops a gout attack after taking such medication, it is called as secondary gout. In short, diuretics can leave you dehydrated, which can result in an excess buildup of uric acid in your blood, thereby increases your risk of having gout.
- Genetics - Regardless of how much you take care of your body, if your genes make your body produce too much uric acid or fail to excrete it properly, you can develop gout. The condition is hereditary in nature and may be passed on from parents to their children. It is also called as primary gout. This is yet another reason why you need to opt for regular checkups with your doctor to know a few preventive measures you can do to minimize your risk of having gout.
- Chemotherapy - A gout attack can also be a side effect of chemotherapy. Chemotherapy is about exposing your body to high radiation in the hopes of killing cancer cells. While the method may be effective, the problem is that high doses of radiation can also kill the healthy cells. This treatment also results in the buildup of uric acid in the blood, as well as inflammation of the joints, which results in gout. If you are scheduled to receive some chemotherapy, your doctor would advise you of the risks and even prescribe some medications to offset the side effects of chemotherapy. It is important that you go over all of the risks associated with this particular treatment since gout is a serious condition with no cure at the moment.
- Obesity, high blood pressure, and diabetes – These conditions may push out uric acid crystals into the joints due to high blood pressure levels, which is why you need to opt for a healthier lifestyle with a better diet to lose all that excess weight.
2) Lifestyle triggers:
- Intake of purines - Consuming foods that have high purine content such as sweetbreads, meat, beef, pork, lamb, and other organ meats will raise your uric acid levels and perhaps lead to gout if left unchecked. It is important that you cut back down on meat and seafood and opt for healthier alternatives. For example, you can eat more celery, as it contains various antioxidants, which can help by actively reducing the excess uric acid buildup in your body. You can consume celery as it is or use its extract. Additionally, you can also add celery to various food items that you can cook at home.
- Excessive alcohol consumption - Alcohol has been shown to raise the risk of gout among people, so excessive drinking of beer and spirits may create an environment for gout to develop. It is important that you avoid alcohol altogether if you are suffering from gout since excess alcohol is toxic and it directly affects your liver and kidneys. It is essential that you limit your alcohol intake as it can exacerbate your current condition. Moreover, alcohol dehydrates your body, thereby enabling more uric acid to build up in the joints, causing gout to flare up again with its debilitating pain.
- Crash dieting - Severe dieting to reduce weight may affect the body's normal metabolism as well as raising the level of uric acid in the body. If you want to lose weight, consult your doctor as well as a dietitian for an effective weight loss and dietary plan, particularly one that can help fight gout effectively by providing your body with the required antioxidants, nutrients, and vitamins.
- Dehydration - Inadequate intake of water raises the level of uric acid in the body. If the body is depleted of water over a prolonged period, it can lead to the accumulation of uric acid in the bloodstream. It is important that you regularly drink water, especially if you are suffering from gout. By drinking enough water, you actually help flush out the excess toxins including uric acid from your body. Your kidneys will excrete the excess uric acid from your body and at the same time, ensure that the remaining uric acid in your body is at normal levels. So if you do suffer from gout, make sure that you drink the recommended amount of water each day to remain hydrated.
- Aerated drinks - Soft drinks usually contain a high percentage of high-fructose corn syrup, which can be more harmful than alcoholic drinks for gout patients. Unlike glucose, which is required by our body, fructose has no health benefits. Instead of consuming aerated drinks altogether, opt for healthier variants such as freshly squeezed fruit juices, as it can provide your body with the required vitamins and minerals it needs without fructose. Moreover, drinking cherry juice should be extremely beneficial on account of the fact that cherries, especially black cherries, contain high levels of antioxidants, which help reduce joint inflammation.
A typical gout attack causes intense pain in the joints, which becomes unbearable. It usually affects the smaller bones in the feet. These episodes of pain occur late at night or early mornings. Studies have shown that weather conditions also affect gout patients. Hot and humid weather dehydrates the body cells leading to more frequent episodes of pain. The pain is so severe that it becomes difficult to move or carry out normal physical activities.
Gout pain is controlled with the help of painkillers. Although the pain may subside within 5-7 days, a relapse is common. Changes in lifestyle and dietary intake can keep the condition under control. So the moment you start experiencing gout symptoms, you need to consult your doctor for effective medications, which can help alleviate your symptoms and allow you to manage your condition better.