Gout or gouty arthritis is a disease caused by a metabolic disorder that leads to deposition of uric acid in your joints. Gout is a very unpleasant disease, but it is rather easy to cure. Gout occurs relatively seldom. Although people use the word “gout” very often to define various problems with their joints. For example, many old ladies misuse the word gout for arthritis of the big toe. In reality gout arthritis can affect big toes, however, it usually occurs in men.
A century ago gout was regarded as exclusively male disease. But nowadays, because women eat better, consume more meat and sausages, gout has become much more common among female than, for example, 70 years ago.
In addition, gout among women occurs at present more often because of the use of certain drugs. In the first place it concerns medication against high blood pressure. Some drugs for lowering your blood pressure lead to increased concentration of uric acid in your body, if taken for a long time. Nevertheless, gouty arthritis in men manifests itself more acutely and more “aggressively” because male sexual hormones have noticeable influence on the concentration of uric acid in their bodies.
In this article we dwell on the signs and symptoms of gouty arthritis, as well as a special diet and treatment for this disease.
Signs of Gout
Is gout a form of arthritis? “Classical” gout belongs to a group of arthritis. It occurs in people with a genetic predisposition to this disease. Moreover, potential patients may not even be aware of their inheritance. For example, if a person and his or her parents or relatives live a healthy lifestyle, do not abuse alcohol and eat good food, the disease may not appear. Nevertheless, it will be present in a latent form. If you have such a predisposition to gouty arthritis, you can trigger this disease by an unhealthy lifestyle.
As a rule, if you are overweight, abuse alcohol, or so-called “purine foods”: meat, fish and salty food, bran, beans and chocolate, you run a risk of developing gout. When you have excessive amount of the listed products, you provoke an increased production of uric acid in your blood, which in its turn forms poorly soluble salt of sodium urate. When the concentration of uric acid in your blood reaches a maximum level, its salt in the form of microcrystals is deposited in the joint cavity, forming there co-called “deposit”.
The presence of microcrystals of sodium urate in your joint cavities is a serious irritant for the development of gouty arthritis. Nevertheless, the crystals can be present there for a long time without any symptoms, until something provokes the onset of the disease. It can be physical overload, stress, prolonged fasting or too much “purine foods” and alcohol. Regular acute gouty attacks are the main symptom of this disease.
Gouty Arthritis Symptoms
Among the first gouty arthritis symptoms is severe pain. The first attack of acute gouty arthritis is almost always short-term. Attack usually begins suddenly, often at night. In most cases gout affects the big toe (one or both) joint on your foot. Less often gout attacks your hand, knee, ankle or elbow joints.
Patient have severe pain that is very difficult to tolerate. The affected joint swells, turns red, the skin over it becomes bright red or crimson and hot at a touch. Even the slightest pressure on the affected joints or the slightest movement of it causes unbearable pain. After 3-4 days of such sufferings, pain disappears as if nothing had happened.
However, after a while pain suddenly repeats. At the beginning of the disease the intervals between gouty attacks are long enough; they last from one to eight months, and the attacks themselves are short. With time the disease progresses and its pathophysiology changes: attacks last longer and the intervals between them become shorter. The disease turns into its chronic form.
Eventually, there comes a time when joint pain becomes constant, and the intervals between attacks are virtually absent. This condition is called “gouty status” or chronic gouty arthritis, which leads to destruction of articular cartilage and the bones adjacent to such a joint acquire particular defects, which are cavities filled with microcrystals of sodium urate.
Furthermore, the crystals of sodium urate can be accumulated even under your skin, forming whitish solid nodules filled with pasty mass. Sometimes, they break through and uric acid crystals go out. Fortunately, after a few days a wound heals. In severe cases chronic gout is almost always accompanied by the deposition of urate in kidneys, which leads to pyelonephritis.
It is important to know that female gout is milder. Women rarely have acute gouty attacks. Most often, female gout manifests itself with blurred chronic pain in their knee or ankle. An experienced physician can find out the difference between gout and arthritis in such cases only by severe swelling of the inflamed joint, which is not typical for osteoarthritis.
Gouty Arthritis Pictures
Diagnosis of Gout
Suspecting gouty arthritis, a competent rheumatologist will ask a patient to undergo an X-ray of the hands and feet and a complex blood test.
Your doctor has to detect on the radiographs of your hands and feet typical gouty “punches” in periarticular bone. And your blood test will show an increased level of uric acid. If such an increase is clearly expressed and is combined with the presence of “punches” in your bones and typical arthritic pain, the diagnosis is considered valid, and your doctor can prescribe correct gouty arthritis treatment.
The problem is that, if you do the blood test while you have an attack, the analyses might not reveal any deviations, because the maximum amount of uric acid goes into your inflamed joint. That is why you need to measure the level of uric acid in your blood several times. Without proper diagnosis and treatment gout can lead to very undesirable consequences not only for your joints, but also for your kidneys.
It is very important to make the correct diagnosis as soon as possible, because gouty arthritis is relatively easy to treat and correctly prescribed medicine brings desired results and pain relief very quickly.
Gouty Arthritis Treatment
Of all the possible types of arthritis gouty arthritis is the most favorable because it is very easy for a competent expert to cure this disease.
However, there is one big difficulty – many patients with gout do not want to accept the conditions that are necessary for recovery. They include mandatory sticking to a gouty arthritis diet. Patients must reject the food (and alcohol) which caused a metabolic disorder. Most patients do not want to follow these rules on nutrition.
You should understand that it is impossible to recover without changing your lifestyle, no matter what potent drugs you take. Besides such a strict diet is a temporary measure and a perfect natural remedy against gout.
Drug treatment of gouty arthritis consists of two components: treatment of an acute attack and therapy of gout itself.
To relieve an acute gouty attack doctors successfully use nonsteroidal anti-inflammatory drugs or a special short-acting drug – colchicine. Topically you can apply home remedies or herbal compress, but consult with your doctor first.
Such drugs are taken in a short 3-7 day course. When the attack has gone, you have to take a special agent which reduces the formation of uric acid in your body.
Sticking to the diet and taking special medicine results in normalization of your state within the first month of therapy. Later the attacks become weaker and occur less frequently, until they eventually stop. About a year later, it is possible to cancel either diet or medications.