Everything You Need to Know About Gout

Arthritis is the general term used to describe joint pain. It’s more prevalent among those who are older but can happen to anyone regardless of their age or sex. It’s main symptom is causing pain in the tissues where the bones meet called joints. One type of arthritis is gout. In this article, we discuss what is gout and how to manage its symptoms and triggers.

What is gout?

Gout is a type of inflammatory arthritis, which means that it stems from the body’s immune system instead of wear and tear of the joints. When a person suffers from some type of inflammatory arthritis, their immune system mistakenly attacks the body’s tissues and cause extreme pain.

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This condition commonly occurs among men, especially those who are older than 40 years old. There are generally four types of gout: asymptomatic, acute (a typical flare-up), intercritical, and chronic. Generally, gout flare ups can happen at any time, and may last for either short or longer periods. 

What causes it?

Gout often stems from hyperuricemia, a condition where there is too much uric acid in the blood. Uric acid comes from purines, which can be found in the food that you eat (on top of the ones that naturally occur in the body). 

Typically, the kidneys expel excess acid through the urine. However, when the kidney can no longer get rid of the excess uric acid, it may start to build up in the body and result in uric crystals. These uric crystals usually form around cartilage or other joint tissues, but may also accumulate under the skin or even in the kidney itself.

Sometimes, uric crystals can stay in the joint or the cartilage for years without causing any discomfort. However, once these crystals make their way into the synovium (the tissue that lines joints), it can cause extreme pain or severe inflammation.

It’s important to note that the body naturally produces urate, which is not an immediate cause for alarm. Sometimes, a person with hyperuricemia won’t show any gout symptoms and not need treatment. 

What are the symptoms?

The main symptom of a gout flare is the sudden pain in the joints, usually in the big toe. During an onset of a gout flare, the affected joint may appear red and/or swollen, and may feel hot. Gout flares can also come with extreme tenderness of the affected joint, to the point that even the slightest touch feels uncomfortable.

Other symptoms of a gout flare include discomfort after the pain subsides (usually after the first 12 hours) and not being able to move your joints as much (limited range of motion). Gout can occur in other joints like the fingers, wrists, elbows, knees, and ankles.

What are the risk factors of gout?

Men are generally more prone to developing gout. Women who are in menopause are also more at risk of gout. The following risk factors may also increase your chances of hyperuricemia and gout:

Consuming alcoholic and/or sugary drinks. Things like beer, fortified wines, and spirits can cause a spike in uric acid. Sodas and other sugary drinks can also raise a person’s levels of uric acid.

Eating food rich in purine. Some seafood such as anchovies, sardines, mussels, and scallops are food high in purine which should not be eaten in excess. Meat like bacon and liver are also foods that can increase a person’s levels of uric acid.

Being obese or overweight. Those who are obese or overweight usually produce an excess of uric acid.

Having preexisting conditions. Some medical conditions such as heart disease and kidney dysfunction can cause high levels of uric acid in the blood.

Taking certain medications. Diuretics and medications that treat high blood pressure, cholesterol issues, and psoriasis can trigger a flare up. Some chemotherapy medicines can also do the same.

Having family medical history. If someone in your family has gout, then you and other family members are at risk of developing this condition as well. 

Being dehydrated. Not drinking enough water can affect kidney functions and lead to hyperuricemia.

How do you treat or manage gout?

Gout is a joint condition that can only be managed, not cured. Thankfully, medicine to lessen the pain and discomfort of a flare-up are available. During the onset of symptoms, your doctor may recommend non-steroidal anti-inflammatory drugs (NSAIDS), colchicine, and corticosteroids.

Your doctor may also recommend medications for managing your uric levels such as Febuxostat, Allopurinol, and Pegloticase.

Can you prevent it?

Those who are at risk of developing gout can prevent a flare up by maintaining a diet that is low in uric acid. This means avoiding large amounts of red meat, seafood, alcohol, and sugary drinks. It’s also a good idea to drink lots of water everyday (about 2 liters) and to maintain a healthy weight.

If you suspect that your medication is causing uric acid problems, consult your doctor. 

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Key takeaway

Gout is a type of inflammatory arthritis characterized by pain in the joints (commonly the big toe). This joint condition is caused by excess uric acid in the blood that causes uric crystals that can cause pain and inflammation in the joint tissue or cartilage. While not curable, it is preventable with a balanced diet that’s low in uric acid, proper hydration, and maintaining a healthy weight. 

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