What Is Gout?
Gout is type of inflammatory arthritis that is associated with higher than normal levels of uric acid in the blood (hyperuricaemia). People with normal uric acid levels may also experience gout.
Gout occurs when there is excess uric acid in your blood that is not properly eliminated from the body. Uric acid forms crystals that then deposit in the joints.
An acute gout episode presents with a severely painful and inflamed joint.
Chronic gout is known as tophaceous arthritis and can occur after years of having many acute gout episodes. Over time, the gout attacks lead to progressive damage of joints.
A worldwide trend has shown gout to almost double in prevalence over the past decades. It is one of the oldest known medical conditions and found even in Egyptian mummies.
Gout affects males more than females. Postmenopausal women may be affected more often than premenopausal women.
Gout is diagnosed by typical clinical features. Usually, a uric acid blood test will be done. Sometimes blood tests for inflammation such as ESR or CRP will be added, or a work-up for chronic arthritis (such as rheumatoid or auto-immune arthritis) if the diagnosis is not clear.
If the doctor suspects long term damage to a joint, he may request a Xray.
What Are The Symptoms Of Gout?
An acute gout attack presents with an acutely painful joint(s), that is swollen, warm and red. The big toe is most often affected, although other joints may also be involved.
Often it is impossible to put weight or strain on the joint due to pain. The pain associated with gout has often been described at a similar intensity as childbirth!
Chronic tophaceous gout usually presents with gouty deposits- small “lumps” of crystals- that can be seen under the skin overlying a joint. These tophi deposits in the joint lining may lead to progressive destruction of the joint, and the patient may then present with symptoms similar to osteoarthritis.
A patient who has chronic gout may still have flare-ups/ acute gout episodes.
What Are The Causes Of Gout?
- Uric acid is a natural breakdown product of proteins called purines. Purines are found in your body’s DNA, as well as in foods such as red meat and seafood.
- Gout is caused by an abnormality in uric acid metabolism. There may either be an overproduction/ overload of uric acid, or an under-excretion of uric acid by the kidneys:
- Contributory causes to gout:
- Excess intake of purine-containing foods.
- Uric acid is excreted by the body through the kidneys. If there is an abnormality with the kidneys, purines may build up. Kidney failure, as well as genetic abnormalities of kidneys, may predispose to gout.
- Certain drinks also influence the metabolism of uric acids such as alcohol and carbonated drinks. Alcohol increases the production of uric acid and lowers the excretion thereof.
- Increased cell breakdown (leading to increased uric acid) in patients with on cancer treatment.
- Obesity. Patients who are overweight have more fat cells and thus a larger turnover of uric acid.
What Are The Things One Should Do To Manage Gout?
- Lose weight. Obesity has in increased incidence of gout due to greater body fat percentage.
- Drink two litres of water a day- it helps to assist your kidneys in eliminating uric acid
- Identify which foods are your triggers for gout, and be sure to avoid them as much as possible.
- Exercise at least 30minutes (moderate intensity) five days a week. This helps your bid rid toxins and fight inflammation.
What Are The Things One Should Avoid To Manage Gout?
- Do not consume food high in purines.
- Do not eat large meals/binge eat as this may overwhelm your body’s ability to process purines. Rather take smaller, regular meals.
- Don’t leave gout untreated, especially if you suffer from frequent flare-ups.
What Are The Best Foods For Gout?
Carbohydrates are safe, although they should be consumed in moderation.
- Vegetable proteins such as tofu and soya are alternatives to animal protein and have a lower risk of gout in predisposed individuals.
- Fruit may be used in moderation.
- Dairy and coffee have shown to be beneficial in some studies.
What Are The Worst Foods For Gout?
- Organ meats
- Red meat
- Game meats
- CO-containing drinks
- Alcohol- Wine and beer
- High amounts of fruit sugars (fructose) such as purely concentrated fruit juices.
What Are The Medicines For Gout?
What Are The Tips To Manage Gout?
Vitamin C supplements, taken in high doses has shown some benefit in gout.