Discover the essential facts about gout – a type of inflammatory arthritis that causes painful flare-ups in the joints. These flare-ups often start in the big toe but can also occur in other joints such as the elbows, wrists, fingers, knees, and ankles. Gout is caused by a buildup of uric acid in the blood, which leads to the formation of needle-like crystals in various parts of the body. While high levels of uric acid are a risk factor for gout, not everyone with elevated levels will experience flare-ups. Men are more commonly affected by gout, but women can also develop the condition, especially after menopause. It's important to understand the symptoms, risk factors, and potential complications of gout in order to effectively manage and prevent long-term damage. Treatment options, including medication and lifestyle changes, can help control flare-ups and reduce the risk of complications.
Understanding Gout
Gout is a type of inflammatory arthritis that causes painful flare-ups. Although the main symptom associated with gout is pain in the joints, and most commonly the big toe, gout is a serious disease that can have negative impacts almost anywhere in the body. Gout can also flare up in other joints such as the elbows, wrists, fingers, knees, ankles, and even the spine. It happens when there's a buildup of uric acid in the blood that causes needle-like crystals to form in the bones, joints, kidneys, heart, and eyes, which can cause damage over time.
High levels of uric acid don't always mean you'll get gout. Around 2 in 3 people who have higher levels of uric acid don't have gout flares. Gout affects men more often, but women can also get gout. 5 in 100 people with gout are women. This is because women naturally have lower uric acid levels compared to men, and the female hormone estrogen helps the body push uric acid out through urine. Levels of uric acid tend to rise after menopause when estrogen levels drop, which increases the chances of gout.
In the past, gout was called a “disease of lords” or a “disease of kings,” as it was associated with wealthy males. That has led to a lot of misconceptions and stigma surrounding the condition, with many people suffering in silence or feeling blamed for living with the disease. Gout can also be misdiagnosed as another form of inflammatory arthritis called pseudogout, where there's joint pain and swelling, but it's due to calcium build-up, not uric acid.
Causes of Gout
Uric acid is produced in your body when purines break down. Purines are found naturally in the body but are also present in certain foods. Your kidneys normally flush out extra uric acid, but if they don't, uric acid can build up throughout your body. That's why people with chronic kidney disease or reduced kidney function have a higher risk for gout.
Risk factors for gout include genetics (a family history), certain health conditions like kidney disease, obesity, metabolic syndrome, or high blood pressure, and taking certain medications such as immunosuppressants or diuretics (water pills). Additionally, a diet rich in foods that are high in purines like red meat, liver, certain seafood, alcohol, and sugary drinks can also increase the risk of gout. However, despite what people think, diet is not the main cause of gout, and many people who eat healthy and do not drink alcohol still develop gout. Genetics, family history, and reduced kidney function are the main factors leading to the development of gout.
Certain communities of color are also at a higher risk of developing gout. Gout is most common among Black Americans, and Asian Americans and Asian Pacific Islanders also have a higher risk of the disease.
Symptoms of Gout
The common symptoms associated with gout include sudden and severe pain, often in the big toe but also in the small joints of the feet and hands, knees, ankles, wrists, and elbows. Other symptoms include swelling, redness, and warmth in the affected area. These symptoms are typically worse in the first 4 to 12 hours after they begin. If gout is not controlled, flare-ups can start happening more often and last longer.
It's important to treat gout because uncontrolled gout can cause other health problems. These include joint and bone damage, including erosion of the joints and bones, the development of tophi (gouty lumps) on the fingers, hands, feet, elbows, or back of the ankle, and kidney stones and the development or worsening of chronic kidney disease due to uric acid build-up in the urinary tract. The build-up of uric acid can also lead to permanent damage in the bones and joints, as well as a higher risk of cardiovascular disease.
Duration and Frequency of Gout Attacks
People with gout can experience flares that last for 1 to 2 weeks. These flares often follow a period of time with no symptoms, known as remission. However, even during remission, uric acid can still be building up in the body. A gout flare may only happen once in your life, or it can become chronic and gradually get worse over time, causing permanent damage throughout the body after several years of no treatment.
Treatment of Gout
Gout treatment involves managing flares and preventing future flares and long-term complications such as joint damage. It's a good idea to go to a gout specialist, such as a rheumatologist or nephrologist, if you're having symptoms because gout symptoms can look like other inflammatory conditions that cause joint swelling.
Different medications can be used to treat gout and prevent long-term damage to your joints. Anti-inflammatory medications such as ibuprofen, steroids, or colchicine can help reduce pain and swelling during a flare-up. To address the root cause of gout, excess uric acid, you can take medicine to lower the uric acid levels in your blood, which can help reduce the risk of complications.
There are also things you can do on your own to help prevent gout flare-ups, such as making diet changes, limiting alcohol intake, reducing the consumption of beverages that contain high levels of sugar, and maintaining a healthy weight through regular exercise.
Living with Persistent Gout
For some people, gout may persist despite oral medications. In such cases, it's important to discuss different treatment options with your healthcare provider. They may recommend alternative medications or therapies to manage the condition.
It's important to maintain communication with your healthcare provider about your symptoms and advocate for what you need. Keeping a log of your gout flares, including details about pain intensity, location, timing, stressors, and the impact on your daily life, can be helpful during discussions with your healthcare provider.
Some questions you may want to ask your healthcare provider include inquiries about your uric acid level, the potential causes of your gout, the need to see a rheumatologist, the possible side effects of medications, the expected timeline for symptom improvement, the duration of medication usage, and how to manage other health conditions alongside gout. Your healthcare provider can provide resources to help manage the condition and support you in the self-management of gout.
Coping with Gout
Gout is a chronic condition that requires long-term management. Medication, healthcare providers, and self-management strategies all play a role in managing gout effectively. It's important to work closely with your healthcare provider to develop a comprehensive treatment plan and follow their recommendations.
Support resources are available to help individuals cope with gout. These resources can provide education, tips, and support to help manage the condition more effectively and improve overall quality of life. Taking advantage of these resources can help individuals feel more empowered in their journey with gout.
Dispelling Stigmas Surrounding Gout
Historically, gout was associated with wealthy males and was given stigmatizing monikers such as the “disease of lords” or the “disease of kings.” These misconceptions and stigmas have contributed to the silence and blame surrounding the condition. However, in recent times, there have been efforts to destigmatize gout and change the views on gout and its sufferers. It's important to recognize that gout is a medical condition that can affect anyone, regardless of their social status or gender. By promoting awareness and understanding of gout, we can work towards dispelling the stigmas surrounding the condition and supporting individuals who live with it.
In conclusion, gout is a painful and chronic condition that requires ongoing management. Understanding its causes, symptoms, and treatment options is crucial for individuals living with gout and their healthcare providers. By maintaining open communication with healthcare providers, seeking appropriate treatment, and utilizing available resources, individuals with gout can effectively cope with the condition and improve their overall well-being. Through education and destigmatization efforts, we can create a more supportive and empathetic environment for individuals living with gout.
Source: https://www.healthywomen.org/condition/what-you-need-to-know-about-gout
