Does gout affect you? If you or a loved one suffer from acute attacks of gout, you will be aware of how debilitating this can be. Gout can be a recurring problem that is very difficult to live with, but the good news is that it can be treated when you seek expert help. As with any problems of an arthritic nature, we strongly advise you to seek advice and treatment as soon as possible, as this limits the progression of the condition and enables you to retain as much mobility as possible in the future. There is much debate about the best ways to treat gout, and we will explore these in this article.
What is Gout?
Gout is a condition often associated with a medieval lifestyle, and many people do not realise that it is still a problem today. Gout is a form of arthritis which most commonly affects the big toe, but may affect other joints, usually one at a time. Gout is caused by a build up of uric acid, and can cause intense pain in the affected joint.
Gout usually leads to severe pain in the affected joint for a period of about 36 hours, and this is usually followed by discomfort in the joint which can last for several days or even weeks. The joint will appear swollen and red, and you may find that your mobility in this joint is limited. Gout often recurs, and you may find that the same joint is affected over and over again, or that the condition recurs in a different joint. Episodes of gout are often called flare-ups.
Why Does Gout Develop?
Gout is a condition that is more common in men than in women, and it is caused by high levels of uric acid in the blood, also known as hyperuricemia. Uric acid production may be excessive in some people, or levels may be increased by eating certain foods and drinks that contain high levels of purines. This condition may also result from normal levels of uric acid if the kidneys are unable to remove it from the body via urine in the usual way.
High levels of uric acid can lead to the formation of crystals, which build up in and around the joints and cause an episode of gout. Those most likely to be affected by gout may:
- Be obese
- Have a family history of the condition
- Take certain medications such as aspirin, niacin or levodopa
- Have had a previous gastric bypass or transplant
- Have another arthritic condition, such as rheumatoid arthritis or psoriatic arthritis
- Drink more alcohol than recommended
- Drink a lot of sugary drinks
- Eat foods that are high in purines, including organ meats, red meats and some seafoods
- Have high blood pressure
- Have kidney or thyroid gland problems
If you are aware of any existing problems or a family history that may predispose you to gout, it is important to ensure that your doctor is aware of this.
A Healthy Diet Can Help
Managing your pain will be easier if your diet does not predispose you to further episodes of gout, and it is important to be aware of how you can influence this. You should reduce or cut out foods that are high in purines, and avoid alcohol and sugary drinks. Drinking plenty of water and taking regular exercise is crucial to a healthy lifestyle, and you should maintain a healthy weight in order to reduce your risk of the condition recurring.
How Does Gout Affect Daily Life?
Gout is most common amongst men aged 40-50, and more than half of gout patients will have a second attack within a year of diagnosis. Episodes of gout can vary in intensity, and may affect different joints in different people. Diagnosis will involve ruling out infections or injuries which could also cause pain in the joints, and an expert in arthritic conditions will usually diagnose gout and rule out other forms of arthritis using ultrasound or MRI scans that examine the affected soft tissues and bones.
If gout remains untreated, it can lead to ongoing pain and limited mobility, as well as causing kidney stones if the excess uric acid builds up in the kidneys. This may increase the risk of developing other serious health conditions.
If you think you are experiencing an episode of gout, you should make an appointment with your doctor and ask for a referral to a specialist in this area. You should also increase your fluid intake and try to reduce the stress in your daily life, as this can worsen the problem.
Home Treatments for Gout
Although it is important to work with a specialist in arthritic pain to treat your gout, there are some measures you can take at home to relieve your pain in the moment. These include:
- Taking anti-inflammatory medications. As soon as you notice gout pain, you can try taking anti-inflammatory medication such as ibuprofen, as long as this is not contraindicated for you.
- Icing the affected joint. Applying ice to the joint that is affected by gout can help to relieve the pain and swelling and reduce the symptoms of the gout.
- Elevating the affected joint. When you have an episode of gout, it can help to elevate the affected joint to help relieve swelling and inflammation, and to rest the area. Stress can also exacerbate the problem, so this physical rest can help.
When you experience an episode of gout, you are likely to find that the first 36 hours are the most painful. Symptoms should begin to ease after this, and will usually be resolved within around ten days.
Treatment for gout will may involve medication to reduce the levels of uric acidic in the body, or to relieve the joint pain this causes. A specialist will work with you to manage your pain and mobility in the long term, and your treatment recommendations will depend upon the way the condition manifests for you.
Peter Browne, Consultant Rheumatologist in Tralee & Limerick
Dr Peter is a qualified rheumatologist who sees patients in Tralee and Limerick. To make an appointment, you will need to visit your GP or other healthcare professional, who can refer you to our rheumatology clinic. If you have a query, you can contact us online for more information