Gout

Overview

Gout can be a common, complex form of arthritis. Gout is characterized by severe, sudden pain, swelling, redness, and tenderness in one or several joints, usually the big toe.

Gout attacks can strike suddenly and often wake you up in middle of the night with the sensation of your big toe on fire. Gout can be severe when the affected joint becomes so hot and tender that it is difficult to bear even the weight of the sheet.

Although gout symptoms can be temporary, there are many ways to prevent and manage them.

Signs

Gout symptoms almost always appear suddenly and often during the night. These include:

  • Intense joint pain.Gout is most commonly seen in the big toe. However, it can also affect any other joint. Gout can also affect the knees, ankles, elbows as well as the wrists, wrists, and fingers. It is most likely that the pain will be severe within the first four to twelve hours following it starts.
  • Lingering discomfort.Some joint discomfort can last anywhere from a few days up to several weeks after the most severe pain has subsided. Later attacks will likely last longer and affect more of the joints.
  • Redness and inflammationThe affected joints or joint(s) become tender, warm, red, and tender.
  • Limiting range of motionGout can cause joint pain and make it difficult to move.

When should you see a doctor?

Call your doctor if you feel sudden and intense pain in a particular joint. Untreated gout can cause more pain and damage to the joints. If you feel a fever or if your joint feels hot and inflamed it is time to seek medical attention. This could be an indication of infection.

Causes

Gout is caused by uric acid crystals building up in the joints. This causes inflammation and severe pain. High levels of uric acids in the blood can lead to the formation of urate crystals. Uric acid is produced by your body when it breaks down purines, substances found naturally in your body.

Some foods contain purines, such as red meats and organ meats like liver. Anchovies are rich in purines. Higher levels of uric acids are promoted by alcohol, particularly beer and sweetened drinks with fruit sugar (fructose).

Uric acid is normally dissolved in blood and passed through the kidneys to your urine. Sometimes, however, your body may produce too much or your kidneys don’t make enough uric acids. This is when uric acid builds up in joints and surrounding tissues, creating sharp, needlelike crystals that can cause inflammation, pain, and swelling.

Risk factors

High levels of uric acids in the body can make you more susceptible to developing gout. You can increase your body’s uric acid levels by the following:

  • Diet.Consuming a diet high in red meat, shellfish, and sweetened beverages with fruit sugar (fructose), can increase levels of uric acids which can increase your risk of developing gout. Gout can also be caused by alcohol consumption, particularly beer.
  • WeightYour body will produce more uric acids if you are overweight. This can make it more difficult for your kidneys to eliminate uric acid.
  • Conditions medical.Gout can be increased by certain conditions and diseases. Untreated high blood pressure, chronic conditions like diabetes, obesity, metabolic syndrome and heart and kidney disease, all increase your risk of developing gout.
  • Some 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. Anti-rejection medications prescribed to patients who have had an organ transplant can also increase uric acid levels.
  • Gout is a family history.Gout is more common in those who have had gout from their families.
  • Age and sex.Gout is more common in men than it is in women, due to lower levels of uric acid. Women’s uric acids levels increase after menopause. Gout is more common in men, who are usually between 30 and 50 years old. However, women tend to experience symptoms and signs after menopause.
  • Recent surgery or trauma.Gout attacks can sometimes be triggered by recent trauma or surgery. A gout flare can sometimes be triggered by a vaccine.

Complications

Gout patients can experience more severe conditions such as:

  • Recurrent gout.Gout symptoms and signs may not be present in all people. Some people may experience gout multiple times a year. Gout attacks can be prevented by taking medication. Gout can lead to joint destruction and erosion if left untreated.
  • Advanced goutGout can lead to deposits of urate crystals under the skin, called TOE-fie. Tophi can form in many areas such as your fingers and hands, your elbows, or the Achilles tendons at the back of your ankles. Tophi aren’t usually painful but can become tender and swollen during gout attacks.
  • Kidney stonesGout patients may develop kidney stones from the accumulation of uric acid crystals in their urinary tracts. Kidney stones can be reduced by taking medication.

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