Gout is a form of arthritis that is responsible for swelling, tenderness, and extreme pain. Usually, it affects the joints and mostly starts with the big toe.
Gout flares frequently begin in the big toe, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).
Particularly in the middle of the night, gout attacks can occur suddenly and without warning, initially causing severe pain. For a couple of days or weeks, a gout episode can last. Some individuals may regularly experience gout flares, while others do not have a gout flare for years at a time.
Due to an excess accumulation of uric acid crystals in the joints and soft tissue, gout occurs , causing inflammation and severe pain.
Symptoms of gout in the big toe
Gout attacks include severe joint pain that arises unexpectedly, accompanied by swelling, tenderness, warmth, and redness or discoloration, including throbbing or burning joint pain.
It can affect the hands, elbows , knees, feet, and toes of an individual.
One report from 2018 notes that the discomfort can be so extreme for certain individuals that they can not bear the weight of a blanket. Within 6-12 hours, the symptoms are usually at their worst. In 1–2 weeks, the infected joint, or big toe, will recover.
The following are signs that a person is encountering a gout attack in the big toe:
- intense joint pain on the big toe
- rapid onset
- swelling and redness or discoloration
- difficulty moving
People who experience gout attacks can find it difficult to walk or stand because of extreme pain and swelling.
To treat gout in the big toe, a person may try the following:
If an person experiences a gout flare in the big toe, according to the Arthritis Foundation, they should contact a doctor to make an appointment.
In the meantime, they can:
- Take medication: A person can take nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen (Aleve), ibuprofen, and celecoxib (Celebrex). However, low-dose aspirin may exacerbate a flare.
- Elevate the foot and apply ice: This may ease inflammation and pain. Elevate the foot so that it is higher than the chest. Use an ice pack and apply to the toe for 20–30 minutes, several times a day.
- Drink fluids: Avoid alcohol and sugary drinks. A person should aim for 8–16 cups of fluid per day, half of which should be water.
To help alleviate pressure on the toe, a person may also use a cane or other mobility aids while they walk. They also suggest that the big toe be taken out of a pair of socks so that there is no strain on the toe. Open toe shoes or sandals are an option.
To avoid repeated gout attacks along with prescribed medications, a doctor can recommend lifestyle changes.
The following lifestyle improvements are recommended by the Centers for Disease Control and Prevention ( CDC):
- reducing alcohol intake and drinks with high sugars
- taking regular exercise and maintaining a moderate weight
- avoiding foods that may cause gout attacks, such as seafood, organ meat, and red meat
Typically, gout treatment includes medications.
Drugs can be chosen by a doctor depending on the condition. Medication can treat gout attack symptoms, avoid further attacks, and lower the risk of complications of gout, such as the development of tophi, according to NIAMS.
Tophi occurs when the crystals of uric acid build up and small lumps form. They can occur anywhere, but at pressure points, such as the elbows, or around hand or foot joints, they usually develop.
Medication can include:
- corticosteroids, such as prednisone
- colchicine, such as Colcrys or Mitigare
Causes and risk factors
Due to an abnormal accumulation of uric acid, or hyperuricemia, gout occurs.
Hyperuricemia is the major risk factor for developing gout, according to the National Institutes of Health ( NIH). A quarter of people with hyperuricemia, however, don’t develop gout.
When the body breaks down purines, it produces uric acid. The kidneys normally extract a certain amount of uric acid from the urine. However, uric acid crystals can form in the joints and soft tissues when they are unable to extract enough uric acid, causing swelling and pain.
The risk of developing gout can also be increased by genetics.
Other factors that can increase the risk of gout, according to the CDC, include:
- Diet: Food can play a role in the development of gout symptoms. Eating seafood, red meat, and drinking alcohol raises uric acid levels in the body.
- Weight: Having overweight increases the chance of developing gout.
- Medications: Certain medications, including diuretics and low-dose aspirin, are associated with gout risk because they increase the level of uric acid in the body.
- Other medical conditions: High blood pressure, diabetes, and kidney disease can increase gout risk.
How does diet affect gout?
NIAMS recommend avoiding foods high in purine, such as:
- seafood, including cod, salmon, and mussels
- organ meat
- red meat
- beverages high fruit sugars
Conversely, some foods have the possibility of reducing uric acid levels, the main cause of gout attacks.
- Cherries: A study has shown that cherries might potentially help lower the level of uric acid in the body, thus reducing gout attacks. However, it would be best to consult a doctor first.
- Vitamin C: According to a 2017 review, consuming vitamin C may increase uric acid excretion.
- Coffee: One study suggests that people who drink coffee regularly are less likely to develop gout. However, more research is needed to confirm these findings
In the United Kingdom, according to the National Health Service ( NHS), some people with gout can develop complications, such as:
- Kidney stones: When urate crystals accumulate in the urinary tract, kidney stones may develop.
- Tophi: These are typically painless, but can appear in awkward places, such as the toes, and can drain white chalky material.
- Joint damage: Some people may experience gout attacks frequently, while others may never have flare-ups. Without treatment, the gout attacks may occur more frequently and cause permanent damage to the joints.
Gout may be debilitating, but there are many improvements in lifestyles and diets that can help prevent gout:
- Maintaining a healthy body weight: Exercise and diet may help reduce uric acid levels in the blood.
- Reducing alcohol intake: Alcohol, especially beer and hard liquor, increases the risk of a gout attack. So, limiting or avoiding alcohol would help the body excrete excess uric acid in the urine.
- Drinking plenty of fluids: Stay hydrated and limit the intake of sugary drinks.
- Eat a low-fat and low-purine diet: Avoid food rich in purine, such as seafood and red meat. Instead, eat vegetables, low-fat dairy products, and plant-based proteins.
To diagnose gout, a doctor has to conduct multiple tests. A joint fluid test, which involves drawing fluid from the affected joint, is one of the tests. An indication of gout is the presence of urate crystals in the fluid.
In order to examine the levels of uric acid in the body, doctors may also conduct blood tests. The NIH notes, however, that certain individuals with high uric acid will never show symptoms of gout, whereas those with low uric acid may have gout attacks.
To find signs of urate crystals and assess the cause of the inflammation, doctors may also perform an X-ray or ultrasound.
When to see a doctor
Gout occurs without warning. Anyone with extreme pain in the big toe, accompanied by warmth, tenderness, redness or discoloration, should seek medical attention immediately.
It can lead to joint deterioration over time, including bone erosion and arthritis, if a person does not receive treatment for gout.
Usually, gout attacks begin with the big toe. Gout attacks can be painful and people usually need medicine to minimize the levels of uric acid and avoid the accumulation of uric acid and joint damage.
Changes in lifestyles and diets can help prevent future attacks.
An individual may raise the foot and apply ice to relieve pain, as well as take medication.
What are the risks associated with gout?
Gout is an inflammatory disease that affects the joints. When high quantities of uric acid, a waste product, build up in the blood, it can cause kidney failure. Swelling and joint discomfort develop as a result of this. Gout has a number of side effects, including joint damage, renal damage, and bone loss.
Excess uric acid causes needle-shaped crystals to develop around joints, causing discomfort.
Gout symptoms can appear in one joint at a time, and the condition frequently begins in the big toe. Individuals may develop symptoms in multiple joints across the body if they do not receive correct therapy.
Around the joints, gout can produce the following symptoms:
- pain, which may feel excruciating if anything touches the joint
- difficulty moving
Gout symptoms might come and go. People with the condition may suffer a flare-up of symptoms that last 1–2 weeks before disappearing.
If left untreated
Gout can not cause mortality directly, but it can lead to life-threatening complications if not treated properly.
Gout can raise the risk of cardiovascular disorders such as heart failure, heart attack, and stroke, according to the Arthritis Foundation. A accumulation of uric acid crystals, which can be caused by a variety of reasons, can damage blood vessels.
Gout raises the incidence of type 2 diabetes in both men and women, with a 71 percent rise in females and a 22 percent increase in males. It’s possible that this is linked to high levels of inflammation. Gout people are more likely to be overweight, have high blood pressure, and have high cholesterol.
Gout has been linked to a 78 percent increased incidence of moderate renal disease. Renal disease can lead to kidney failure if not treated.
Gout may also increase the risk of sleep apnea, a condition that impairs breathing while sleeping. Sleep apnea can put you at risk for a variety of significant health issues, including:
Chronic gout can induce joint swelling and chronic inflammation, both of which can lead to joint damage. Stiffness and deformities are also possible side people.
To avoid joint injury, it’s important to keep gout flare-ups under control. To immediately manage gouty edema, the Arthritis Foundation suggests the following steps:
- Make an appointment with a doctor to get the condition evaluated.
- Elevate the joint and apply ice to it.
- Drink lots of water and stay away from alcohol and sugary drinks.
- Stress can exacerbate gout flare-ups, so try to control or decrease it.
- Request assistance with any chores that may place additional strain on the joints.
Additionally, several drugs can help reduce inflammation and minimize the duration of a gout flare, such as:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
People with significant joint injury may require surgery to repair or replace severely damaged joints.
Fractures of the bones
Gout has been linked to an increased risk of bone fractures by some researchers, while there is considerable debate about this.
In a 2016 study, researchers determined that people with a history of gout have a greater risk of bone fracture.
The researchers discovered that people with gout who used medicine to treat it, such as allopurinol and benzbromarone, had fewer bone fractures than those who didn’t.
Certain drugs known as bisphosphonates can assist people with gout and bone loss minimize or prevent additional bone loss. These are some of them:
- zoledronic acid
Tophi are urate crystal collections made up of uric acid accumulation that can form on joints and cartilage. These hardened crystals can induce lumps of various sizes to grow on various body parts, including:
- the ears
- fingers and hands
- feet and toes
Tophi is a symptom of chronic gout that can appear in people who suffer gout flare-ups often. Tophi are normally not painful, but they can cause joint injury, making it difficult to move the joints.
Without treatment, tophi can develop to problems. It can be painful and deadly if they have an infection or push on a nerve.
Tophi can be treated by lowering uric acid levels. Medication, such as allopurinol, which lowers uric acid levels in the body, may be used. A doctor may raise the dosage of uric-acid reducing drugs to prevent the uric acid from crystallizing in order to get rid of the tophi.
Tophi therapy can take a long time, and people may not observe a reduction in the size of their tophi until after several months of treatment. Tophi may need to be removed surgically in extreme situations.
Although eye parts are an uncommon gout consequence, uric acid crystals can cause damage to the eyelid, cornea, and iris. Tophi can also affect the upper eyelid and other parts of the eyes.
Gout may be treated by reducing uric acid levels and inflammation, which can assist with any gout-related ocular issues. Flare-ups must be treated as soon as important, and this typically entails the use of anti-inflammatory medicines such as NSAIDs or corticosteroids.
Lowering uric acid levels through dietary and lifestyle modifications, as well as pharmaceuticals, can assist.
People with gout are more likely to develop kidney stones. Urate crystals can develop in the urinary system as a result of high uric acid levels. Kidney stones can cause the following symptoms:
- severe pain in the back, groin, lower abdomen, or side below the ribs
- pain when urinating
- brown, red, or pink urine
Doctors may employ an alkalizing chemical and a medicine called allopurinol to dissolve urate stones in people who have gout.
The kidneys are responsible for removing waste products from the body, such as uric acid. When uric acid levels are high, the kidneys may struggle to handle the extra uric acid.
The accumulation of uric acid crystals in the kidneys can decrease renal function and lead to kidney disease or failure.
People with kidney disease may feel tired, weak, or have poor energy in the early stages. Individuals may encounter the following symptoms when their kidney disease progresses:
- swelling of the ankles
- a loss of appetite
Treatment can help reduce and slow damage to the kidneys. Treatments can include:
- taking medications to lower uric acid levels, such as allopurinol, febuxostat, probenecid
- reducing foods high in purine, such as organ meats and shellfish
- drinking plenty of water
- avoiding smoking and certain supplements, such as niacin (vitamin B-3)
- exercising regularly and maintaining a moderate weight
- controlling any other conditions, such as high blood pressure or diabetes
Gout problems can be reduced by taking the following steps:
- eating a nutritious, balanced diet
- maintaining a moderate weight
- controlling any additional conditions, such as high blood pressure or diabetes
- engaging in regular exercise
- taking medications to lower uric acid or accelerate its removal
- limiting or avoiding foods high in purine, alcohol, and sweet fruit drinks to reduce uric acid buildup
- drinking plenty of water
- getting regular kidney function and bone density tests to check for early signs of any problems
Gout management and treatment
Changes in diet and lifestyle, such as the ones listed above, can help control gout and lower the likelihood of flare-ups.
People with gout may require long-term care with modest, regular doses of medicine to decrease uric acid levels and assist avoid flare-ups. Colchicine may be used in conjunction with one or more of the following medications:
If uric acid levels are still high and the preceding drugs aren’t working at their highest suggested doses, an intravenous injection of pegloticase every two weeks may help lower uric acid levels quickly.
When should you see a doctor?
If gout flares up, people should see a doctor to explore the best treatment choices. Within 24 hours of a gout flare-up, anti-inflammatory treatments are most helpful.
If a person exhibits any of the people of gout problems, they should seek medical help. They will also require rapid medical treatment if they exhibit any indications of a cardiac event, such as a stroke or heart attack.
Although gout is not lethal in and of itself, it can cause serious consequences such as joint damage, cardiovascular difficulties, and renal disease if left untreated.
Controlling gout flare-ups and lowering uric acid levels using drugs, as well as dietary and lifestyle modifications, can help manage the disease and minimize the risk of complications.
Bursitis: What are some available treatment option?
Bursitis is a condition that affects the joints and causes discomfort. It happens when bursae, which are fluid-filled sacs that function as a cushion between bones, tendons, and muscles, become inflamed.
In the human body, there are about 150 bursae. They lubricate and cushion the points where bones, tendons, and muscles meet near the joints.
Bursitis causes these bursae to become inflamed, making movement or pressure on the affected region unpleasant.
The parts of the body where a person might get bursitis, the symptoms of the ailment, and how to cure it are all covered in this article.
Bursitis causes pain in the area where the bursa is inflamed.
Bursitis can affect any bursa, although it is more frequent in the following areas:
People may refer to various kinds of bursitis by other names. Tennis elbow, clergyman’s knee, and housemaid’s knee are all common terms.
Bursitis can develop as a result of an injury, an infection, or a pre-existing illness like gout, which causes crystals to grow in the bursa.
Physical trauma can irritate and inflame the tissue inside the bursa. An impact injury or overuse of the joints, tendons, or muscles around the bursa can cause this trauma. Repetitive actions are the most common cause of overuse.
The cause of bursitis might help pinpoint which part of the body is afflicted. The following are some of the possible causes:
- Elbow: Bursitis is a common problem among tennis players and golfers. Repetitive bending of the elbow can lead to injury and inflammation.
- Knee: Repeated kneeling can cause injury and swelling to the bursae in the knee area.
- Shoulder: Repeated overhead lifting or reaching upward can cause bursitis in the shoulder.
- Ankle: Injury to the ankle can result from walking too much and with the wrong shoes.
- Buttocks: The bursae in the lower pelvis can become inflamed after sitting on a hard surface for a long time, such as on a bicycle. A person may notice discomfort in the buttocks and legs.
- Hips: A person can develop hip bursitis due to excessive running, stair climbing, or standing for extended periods.
Infectious bursitis is more common in bursae that are closer to the skin’s surface, such as those around the elbow. A cut on the skin provides an entry point for microorganisms.
Infectious bursitis is caused by repetitive stress and misuse of joints around bursae, just like other types of bursitis. People with immune system disorders, on the other hand, may be at a higher risk of getting bursitis as a result of an infection.
Crystals are more prone to occur inside the bursa in people with specific health disorders. The bursa is irritated by the crystals, which causes it to swell. Gout, rheumatoid arthritis, and scleroderma are among conditions that can cause bursitis.
The severity of a person’s symptoms will determine the treatment for bursitis.
With the use of over-the-counter (OTC) medicines and basic self-care strategies, a person may be able to manage their bursitis at home.
Self-care usually involves:
- Protecting the affected area: Padding can protect the affected bursae from painful contact.
- Resting: Not using the joints in the affected area unless necessary can help reduce inflammation.
- Applying ice packs: Placing towel-wrapped ice packs on the affected area can help reduce pain and inflammation. A person should never place ice directly onto their skin.
- Raising the affected area: Elevating an affected area reduces blood pooling and may help lessen inflammation.
- Taking pain relievers: Ibuprofen is effective as a pain reliever, and it may also help reduce inflammation.
Although most cases of bursitis may be treated at home, severe bursitis may necessitate the use of prescription drugs.
To ease the symptoms, the doctor may inject steroids into the afflicted area. Steroids inhibit the production of prostaglandin, a substance that causes inflammation in the body.
Doctors, on the other hand, should use caution when prescribing steroids. If taken for an extended period of time, these medicines can raise blood pressure and increase the risk of infection.
Furthermore, while steroid injections reduce a person’s symptoms, they may create a delay in detecting other bursae-related diseases. As a result, doctors may miss the best moment for some surgical procedures.
If a bacterial infection is confirmed by a fluid test, the doctor will most likely prescribe antibiotics. In most cases, oral antibiotics will be recommended, but in more severe cases, intravenous antibiotics may be required.
A person may require surgery to drain the afflicted bursa in rare cases.
One or more of the following symptoms may be present in a person with bursitis:
- pain that increases with movement or pressure
- tenderness, even without movement
- loss of movement
Septic bursitis occurs when an infection causes bursa inflammation. A person with septic bursitis may have the following additional symptoms:
- skin discoloration in the affected area
- the affected area feeling hot to the touch
When to see a doctor
Many people treat bursitis at home, but if the symptoms are more severe, they should seek medical help.
More severe symptoms include:
- joint pain that prevents all movement
- pain lasting longer than 2 weeks
- sharp, shooting pains
- excessive swelling, bruising, or skin discoloration
- an X-ray to check for broken or fractured bones
- blood tests to assess for rheumatoid arthritis
- a CT scan or MRI scan to look for possible tendon or joint damage
People can take several steps to help prevent bursitis. These include:
- Protecting vulnerable parts of the body: Knee pads can help people who kneel a lot, and elbow braces can help tennis and golf players. Athletes and anyone who walk a lot should buy a good pair of walking or running shoes.
- Taking breaks during tasks: Aside from taking regular pauses, a person can prevent bursitis by shifting movements to use different portions of the body.
- Managing body weight: An individual who is overweight may have higher joint stress. A person’s weight can be managed to lower the pressure on their joints and reduce the risk of bursitis.
- Warming up before exercise: Warm up for at least 5–10 minutes before engaging in strenuous exercise. Walking at a good pace, running slowly, or riding an exercise bike are all options.
- Performing muscle-strengthening exercises: Strengthening the muscles in the area where bursitis has developed, particularly surrounding the joint, can help to protect the area from further harm.
Bursitis is a condition in which a bursa, a fluid-filled sac that protects joints, becomes inflamed. Bursitis most commonly affects the elbows, knees, hips, and shoulders.
Bursitis can develop when a person repeatedly applies pressure on or moves these joints. Tennis elbow, which is caused by repeatedly bending the elbow, and clergyman’s knee, which is caused by frequent kneeling, are two common types of bursitis.
Bursitis can be caused by impact injuries, and infections can lead to septic bursitis.
Most types of bursitis will go away after a period of rest. Some people, however, may require medicine or even surgery to alleviate their problems.
Protecting weak joints, taking breaks during repetitive jobs, and keeping a moderate weight can all assist to prevent bursitis.
Gout: Things you need to know
Gout is a common form of arthritis, which causes severe joint pain, swelling, and stiffness. It normally affects the big toe joint.
Gout attacks can happen rapidly and keep coming back over time, gradually destroying tissues in the inflammation area, which can be extremely painful. Gout risk factors include hypertension, cardiovascular and obesity.
It is the most common type of inflammatory arthritis in men and while it is more likely to affect men, after menopause, women are more vulnerable to it.
The Centers for Disease Control and Prevention (CDC) estimates that between 2007 and 2008, 8.3 million Americans suffered from gout.
Fast facts on gout
- Gout is a form of arthritis caused by excess uric acid in the bloodstream.
- The symptoms of gout are due to the formation of uric acid crystals in the joints and the body’s response to them.
- Gout most classically affects the joint in the base of the big toe.
- Gout attacks often occur without warning in the middle of the night.
- Most gout cases are treated with specific medications.
Most cases of gout are treated with medicine. Medication can be used to relieve gout attack symptoms, avoid future attacks and reduce the risk of gout complications such as kidney stones and tophi growth.
Medications widely used include non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, or corticosteroids. These alleviate inflammation and pain in gout-affected areas, and are usually taken by mouth.
Medications may also be used either to minimize uric acid production (xanthine oxidase inhibitors such as allopurinol) or to enhance the ability of the kidney to extract uric acid (probenecid) from the body.
The acute gout attack should be at its worst between 12 and 24 hours after it starts out without medication. A individual should expect to recover without treatment within 1 to 2 weeks but severe pain can occur during this time.
Tests and diagnosis
Gout can be difficult to diagnose as the signs are close to those of other disorders when they do occur. Although the majority of people who develop gout have hyperuricemia, it may not be present during a flare. On top of that, gout does not occur in most people with hyperuricemia.
One medical examination that physicians can perform is the joint fluid check, in which fluid is removed with a needle from the affected joint. Then, the fluid is analyzed to see if there are any urate crystals.
Given that joint infections may also cause gout to occur with similar symptoms, a doctor can look for bacteria when performing a joint fluid test to rule on a bacterial cause. The fluid can need to be sent to a laboratory, where analysis will take several days.
Doctors may also do a blood test to determine levels of uric acid in the blood, but people with high levels of uric acid may not necessarily experience gout, as stated. Similarly, some people can experience gout symptoms without having elevated uric acid levels in the blood.
Using ultrasonic scans, doctors can eventually check for urate crystals around joints or inside a tophus. X-rays are unable to diagnose gout but they may be used to rule out other causes.
Gout develops through multiple phases and these are often referred to as specific forms of gout.
A person may have elevated levels of uric acid with no visible symptoms. Treatment is not needed at this point, though urate crystals that deposit in tissue and cause minor damage.
People with asymptomatic hyperuricemia can be recommended to take action to resolve any potential causes that lead to the build-up of uric acid.
This stage occurs when the unexpectedly deposited urate crystals cause acute inflammation and severe pain. This sudden attack is called a “flare” and normally will subside within 3 to 10 days. Stressful activities, alcohol and narcotics, as well as the cold weather, may often cause flares.
Interval or intercritical gout
This stage is the time in between the acute gout attacks. Subsequent flares may not occur for months or years while they can last longer and occur more often if not handled over time. More urate crystals are introduced into tissue during this time.
Chronic tophaceous gout
The most painful form of gout is the Recurrent tophaceous gout. Permanent damage at the joints and kidneys may have occurred. The patient may suffer from chronic arthritis, and develop tophi, large lumps of urate crystals, in cooler body areas such as the finger joints.
It takes a long time to hit the stage of chronic tophaceous gout without treatment-around 10 years. A patient receiving adequate care is extremely unlikely to progress to this level.
Pseudogout is one disease that’s easily mistaken with gout. Pseudogout symptoms are somewhat similar to gout symptoms while thr flare-ups are usually less severe.
The main difference between gout and pseudogout is that rather than urate crystals, the joints are irritated by calcium pyrophosphate crystals. Pseudogout needs a particular kind of gout treatment.
Gout is initially caused by an excess of uric acid, or hyperuricemia in the blood. Uric acid is formed in the body during purine breakdown-chemical compounds contained in large concentrations in some foods such as beef, poultry and seafood.
Uric acid is usually dissolved in the blood, and excreted by the kidneys from the body in urine. If the uric acid is too strong, or not e
There are a number of factors that can increase the risk of hyperuricemia, and hence gout:
Age and gender: men produce more uric acid than women, although women’s uric acid levels exceed men’s after menopause rates.
Genetics: A family history of gout raises the risk of developing a disease.
Lifestyle choices: Drinking alcohol interferes with eliminating uric acid from the body. Eating a diet rich in purine often increases the amount of uric acid in your body.
Lead exposure: Some cases of gout have been related to chronic lead exposure.
Medications: Some medicines can increase uric acid levels in the body; these include some diuretics and salicylate-containing drugs.
Weight: being overweight raises the risk of gout, as there is more body tissue turnover, which means more uric acid production as a metabolic waste product. Higher body fat levels also increase systemic inflammation levels, as fat cells produce pro-inflammatory cytokines.
Recent trauma or surgery : Increases risk.
Other health issues: Renal insufficiency and other kidney disorders can affect the ability of the body to efficiently eliminate waste products, leading to elevated levels of uric acid. Many gout-related disorders include the high blood pressure and diabetes.
Gout usually unexpectedly becomes symptomatic without warning, sometimes in midnight.
The key signs are severe joint pain that causes swelling, inflammation and redness to subside.
Gout mostly affects the big toe’s broad joint but can also affect forefoot, ankles, knees, elbows, wrists and fingers.
The pain can be unbearable. A veteran who visited Birmingham hospital, AL said:
“I’ve been shot, beat up, stabbed, and thrown out of a helicopter, but none of that compared to the gout.”
In some cases, gout can develop into more serious conditions, such as:
- Kidney stones: If urate crystals collect in the urinary tract, they can become kidney stones.
- Recurrent gout: Some people only ever have one flare up; others may have regular recurrences, causing gradual damage to the joints and surrounding tissue.
There are several lifestyle and nutritional recommendations which can be attempted to defend against flares or avoid gout from first occurring:
- maintain a high fluid intake of around 2 to 4 liters a day
- avoid alcohol
- maintain a healthy body weight
Those with gout can manage flare-ups by moderating their diet. A healthy diet can help to relieve symptoms.
To insure that the levels of uric acid in the blood do not get too high, decreasing foods which are rich in purines is fair to try. Here’s a list of high-purine foods to protect against:
- beef kidneys
- dried beans and peas
- game meats
Although decreasing or avoiding such foods is acceptable, a high purine-rich diet has been shown not to increase the risk of gout, or worsen symptoms in research studies.
Asparagus, beans, several other plant-based foods, and mushrooms are also sources of purines, but evidence shows that these do not cause gout attacks and do not affect levels of uric acid.
Various epidemiological studies have shown that purine-rich vegetables, whole grains, nuts and legumes, and less sugar fruits, coffee, and vitamin C add to lower levels of uric acid in the blood, but do not reduce the risk of gout. Red meat, beverages containing fructose, and alcohol can add to the risk.
A good description and understanding of the role of uric acid in gout has been made. Gout is a very controllable type of arthritis, as a result of this and the wide availability of appropriate medications.