Gout affects an estimated 1 out of 20 adults in the United States and about 2 million people use medication to prevent attacks. However, there are still widespread misconceptions about the condition, even among gout sufferers. You can live with the underlying cause of gout for years and even decades and never have an attack. Potentially millions of people are at risk of gout but do not know it. However, knowing the facts about gout and ignoring the myths can help you prevent gout if you never had it before, or drastically reduce the chances of an attack if you are a gout sufferer.
Do you have gout?
Gout is a condition involving the joints but it is not always easy to diagnose without medical training. It is always advisable to consult with a doctor, have a proper medical examination and possibly undergo tests to diagnose whether you have gout or not. The symptoms alone are not always a reliable indicator if the problem you are experiencing is gout or not. The typical symptoms of gout includes:
- Sudden and severe joint pain particularly of the joint at the base of the big toes.
- Swelling, redness and heat of the affected joint.
- Tingling over the joint prior to the onset of pain.
- Discomfort in the joint for weeks after the pain subsides.
However, these symptoms are not uncommon in other joint diseases and a doctor’s opinion is therefore necessary.
Picture of gout of the big toe from Wikimedia Commons
Gout Is A Build Up Of Acid
Gout is a result of uric acid crystals forming in the joint and then irritating the joint tissue. Uric acid is a type of urate. It is more correctly known as monosodium urate (sodium + uric acid). It is naturally formed in the body by the breakdown of cells. However, this is a very small amount. Most of the uric acid found in the body comes from the breakdown of purines, a constituent of dietary protein. Humans cannot metabolize uric acid like other mammals due to the absence of the enzyme uricase. The kidneys filter and excrete uric acid but if this is not done efficiently, the uric acid builds up in the body. It can travel through the bloodstream and become deposited in various tissues.
Gout Is The Same As Arthritis
Most people use the word ‘arthritis‘ loosely thinking that it is a specific disease. Arthritis is a broad term that means inflammation of the joint. There are various different types, the most common being osteoarthritis and second is rheumatoid arthritis. Gout is a form of arthritis, but it is not osteoarthritis or rheumatoid arthritis. In gout there is formation of uric acid crystals in the joint which irritates it. Osteoarthritis is a consequence of joint wear-and-tear with the breakdown of joint cartilage, while rheumatoid arthritis is an auotimmune disease affecting the joints. When the symptoms of gout arise, it is referred to as gouty arthritis. But you can still have gout even if there are no joint symptoms.
Gout Only Occurs In Old Men
This is partly untrue. Gout can affect both men and women. However, it is much more common in men than women. In the United States, studies have found that gout affects about 6% of men and only 2% of women. Another similar condition known as pseudogout affects both men and women equally. It is rare for gout to occur in an adult younger than 30 years of age. The majority of cases occur after the age of 50 years and men who are older than 70 years have a five times higher risk of developing gout than a male in their 50s. When gout occurs in women, it tends to occur later in life as well and usually after menopause.
Gouty Arthritis Only Causes Pain In The Big Toe
Gout more often affects the joint at the base of the big toe. But it can affect many other joints as well. Gouty arthritis can occur in the wrist, elbow, knee and ankle joints although the big toe joint is more commonly affected. It is possible to have gouty arthritis in one of these other joints but not in your big toe at all. One of the first signs to occur is tingling of the joint before the pain starts. When the pain strikes, it is often severe and sudden. The joint appears red and swollen and it is tender to touch. Even after the pain subsides there may be discomfort in the affected joint for days or weeks thereafter.
Gout Sufferers Should Not Take Aspirin
Aspirin is a very effective anti-inflammatory drug. By reducing inflammation, it reduces the associated pain, swelling redness and heat at the site. While aspirin is used for a wide range of inflammatory conditions, it should be avoided in gout. It is not that aspirin cannot be used at all but it is important for a gout sufferer to know that aspirin can actually worsen gout. Aspirin can raise the uric acid levels and it is therefore advisable to use other anti-inflammatory drugs and painkillers such as ibuprofen or corticosteroids. Rather use the drugs prescribed a doctor specifically for gout.
Gout Can Be Diagnosed With A Blood Test
There is no single blood test that can diagnose gout. Tests to measure the uric acid in the blood can reveal whether the levels are too high but this does not mean that a person will definitely have gout. In fact some people with gout have completely normal levels of uric acid in the blood. The diagnosis of gout is largely clinical meaning that the presence of gouty symptoms, especially in a person who responds well to medication that blocks uric acid production and increases its excretion, will help to confirm the diagnosis of gout. However, gout can be diagnosed by aspirating the joint fluid and identifying the presence of uric acid crystals in this fluid.
Seafood Is A Gout Trigger
Seafood is often thought of as the best health option for meat eaters. But gout sufferers need to be cautious about certain seafood. Anchovies and sardines in particular are very high in purines. The components of protein are broken down into uric acid. Therefore a high purine diet is more likely to increase uric acid levels in the blood and lead to gout in people who are prone to the condition. But seafoods are not the only problem. Offals and red meat are also high in purines and so are some vegetables. So avoiding seafood by eating red meat instead is not necessarily helpful. In fact these foods do not have to be avoided entirely but it should be eaten in moderation if at all.