Gout - where does it come from? How does it manifest itself and how to treat gout?

Gout (gout, gouty diathesis, arthritis). In the past, it was defined as a disease of rich people, mostly affecting men in the prime of life. It is an acute inflammation of the joints, which is treated with a proper diet and pharmacological agents. How to deal with this ailment?

What is gout?

Gout, also called gout (when the big toes are affected) or arthritis, is a disease for which an extremely violent and painful inflammation of the joints is specific.

If you experience joint pain, you should consult your family doctor. He can help identify the cause and refer you for further tests

Gout usually affects the metatarsophalangeal joint, but can also take the form of gouty nodules and kidney stones. Gout is also caused by elevated levels of uric acid, which, because it has no drainage, crystallizes and is deposited in joints, tendons and surrounding tissues. The affected areas become swollen, red and extremely painful.

Gout - Symptoms

The symptoms of gout are recurrent bouts of joint inflammation (usually at the base of the big toe, although gout often affects the ankle, finger, knee or wrist joints as well). Symptoms are usually worse at night and last for several hours, which is a result of the lowered body temperature at that time. In addition to the uncomfortable pain, fatigue and high fever may also occur.

Uric acid crystallizing near joints can cause bone erosion, which in turn leads to chronic arthritis. Sometimes the above symptoms disappear within a few days. After the first attack of gout, there is a period of withdrawal of all symptoms. Lack of prompt diagnosis and treatment leads to subsequent attacks being more intense and involving other joints.

Gout is divided into several stages:

• inter-ictal periods;
• acute attacks of arthritis;
• period of asymptomatic hyperuricemia;
• chronic (advanced) gout.

If symptoms are alarming, it is recommended that appropriate diagnostic tests be performed.

What is the course of an acute gout attack?

Acute gout attack or acute arthritis develops as a result of severe fluctuations in the concentration of uric acid in the synovial fluid. Direct factors that can trigger an attack include exercise, alcohol, foods that contain a significant amount of purine compounds, surgery, trauma, and certain medications (such as allopurinol).

During the course of an acute gout attack, redness and swelling occur in the affected joint, and the pain gradually increases, peaking after about 8-12 hours. If left untreated, the attack can last for several hours and up to a week or two.

In the prevention of osteoarticular diseases, it is worthwhile to take appropriate supplementation. 

Gout medications

If you have gout symptoms, consult your doctor urgently, who will examine and assess whether they are indeed indicative of this condition. The doctor will recommend appropriate treatment. 

To make the symptoms less troublesome, you can apply ice or simply stiffen the affected joints.

What is used to treat gout: non-steroidal anti-inflammatory drugs, glucocorticosteroids or colchicine. It is very important to react quickly and carry out treatment!

When you feel the first symptoms of gout, it is necessary to see a doctor. Make an appointment for an online consultation with your family doctor, where you can get answers to your questions and learn about other treatment options.

Gout - Causes

Elevated uric acid levels in the blood (hyperuricemia) result from decreased kidney function. To counteract kidney disease, it is a good idea to strengthen the kidneys with the right supplements.

Uric acidosis also occurs as a result of poor diet: In 12 percent of cases, the disease is caused by eating too many products rich in purines, the chemical compounds responsible for the formation of uric acid. Thus, fructose-sweetened beverages, seafood and meat should be avoided. Alcohol can also play a role in the development of gout.

Gout can also result from a genetic predisposition. People with Lesch-Nyhan syndrome, who suffer from a partial or complete deficiency of the enzyme responsible for controlling uric acid levels, often struggle with arthritis in addition. Patients who have recently undergone surgery, are dehydrated or infected, or have other serious illnesses are also at risk for gout.

Other factors that affect the likelihood of developing gout:

• Obesity;
• high blood pressure;
• coronary heart disease,
• diabetes;
• disorders of lipid metabolism.

Gout - diagnosis

In order for the doctor to diagnose gout, it is necessary to differentiate it from other joint diseases. When diagnosing gout, it is recommended to perform uric acid concentration and daily uric acid loss in urine. Elevated uric acid levels usually indicate gout, but may be normal during an acute gout attack. Analysis of joint fluid under a microscope is a test that can conclusively confirm the diagnosis. The test involves removing fluid from the affected joint and examining it for the presence of sodium urate crystals. This diagnosis also has the advantage of being able to distinguish between gout and pseudogout (the presence of other types of crystals in the joints).

X-rays are also used in the diagnosis of gout, which make it possible to locate erosions, gouty nodules or narrowing of the joint space (they may appear only at an advanced stage of the disease). 

Treatment of gout

Gout treatment aims to relieve pain quickly and prevent gout attacks in the future.

The patient should take anti-inflammatory and analgesic medications prescribed by the doctor, and if the symptoms persist and recur, allopurinol (which reduces the production of uric acid) or probenecid (which increases its excretion) is recommended. It is important to quickly recognize and treat conditions that may accompany gout, such as:

• Disorders of lipid and carbohydrate metabolism,
• urolithiasis,
• obesity,
• kidney disease,
• hypertension.

If necessary, the doctor may also recommend surgical removal of urate nodules and kidney stones.

What treatment to use at different stages of gout:

• Hyperuricemia: in the first place it is important to change the lifestyle, drug treatment is not necessary at this stage;
• Acute gout attack: it is recommended to take non-steroidal anti-inflammatory drugs or colchicine to eliminate the pain as soon as possible. Caution: at this stage of gout, do not take uric acid-lowering treatment because, contrary to appearances, this may worsen symptoms;
• interictal period: keep uric acid levels low to prevent attacks. Sometimes medications are suggested to lower uric acid levels in the blood;
• chronic gout: in chronic gout, further development of the disease is inhibited and its complications are treated. In this case, allopurinol is mainly used to block the production of uric acid.

Diet for gout

Recovery of gout patients can certainly ensure a change in lifestyle and proper diet. Gout often results from eating foods rich in the purines mentioned above. For this reason, a low purine diet is recommended for gout patients.

One of the principles of the diet for gout is to limit fats and increase the intake of carbohydrates.

To prevent the recurrence of the disease, it is worthwhile to limit foods with a high content of them - offal, meat (beef, pork, bacon), game, fatty sauces and beer. The correct composition of the menu is of considerable importance and is considered dietary treatment.

The low-purine diet consists, among other things, in the exclusion from the menu:

• Yeast;
• Offal;
• venison;
• Bone extracts;
• sea fish such as sardines, herring and sprats
• Mushrooms;
• Spinach;
• Legumes;
• coffee and tea;
• Cocoa.

Among the products that should be avoided in arthritis are sausages, canned foods, fatty foods, alcohol, and hot spices, bone broths, mushroom broths or rhubarb. It is better to avoid preparing food by frying and baking, and flour can be used for thickening. Vegetables and fruits should be eaten raw or cooked.

Gout sufferers who want to limit purines can resort to lean meat, but it is recommended to cook it in a considerable amount of water. Other products that can be included in the diet of a low purine diet are eggs, skim milk, dairy products, cereals, rice, honey, sugar, vegetables and fruits. Drinking liquids with lemon can be helpful in reducing hyperuricemia.

IMPORTANT

Doctors report that obese people are at higher risk for recurrence of gout symptoms, so it is advisable to stay physically active in addition to eating a healthy diet.

Additional dietary recommendations for gout patients:

• Eat 4 to 5 meals throughout the day, preferably at equal intervals;
• the last meal of the day should be eaten no later than three hours before bedtime;
• if the patient suffers from kidney stones in addition to gout, he should drink three liters of fluid daily
• During an acute attack of gout, one must be especially careful with the diet - a meatless diet is then recommended, especially gruel.

Find more information here: https://cateromarket.pl/blog/dna-moczanowa-podagra-jaka-diete-stosowac