Gout affects over 8 million Americans and 1 in 5 sufferers have a family history of gout. Almost 2 million gout sufferers use medication for the condition and the condition is becoming more common in the United States, which is partly attributed to an aging population and rising obesity rates. However, gout is not just an American population. It affects people across the globe although the incidence varies due to a number of factors, including environment, genetics and diet.
How To Spot Gout
Gout is a form of arthritis, and it is not the most common type of arthritis. Any joint inflammation is referred to as arthritis. Some may be due to wear and tear as is seen in osteoarthritis, the most common type of arthritis, which is more of a degenerative than inflammatory condition. Arthritis may also be due to autoimmune factors as is the case with rheumatoid arthritis. In gout the problem lies with the uric acid levels in the bloodstream.
Normally uric acid is excreted by the kidneys. However, when there is too much uric acid being produced in the body or if the kidneys cannot efficiently excrete uric acid, then it builds up in the bloodstream. Eventully this uric acid forms urate crystals in the joint which then injury and irritate the joint lining leading to arthritis. Therefore this is known as gouty arthritis.
Read more on gouty arthritis.
Gout is usually easy to spot as it typically causes a red, swollen and painful toe joint. The big toe is most commonly affected. However, it is not uncommon for gouty arthritis to sometimes be mistaken for other types of arthritis like rheumatoid arthritis, septic arthritis (due to an infection) or traumatic arthritis (due to joint injury). Arthritis, particularly affecting the big toes, should be suspected as gout in people who are at high risk.
Who is more likely to get gout?
Any person with elevated levels of uric acid may develop gout, irrespective of diet, body weight, age or gender. However, people with one or more of these risk factors are at a greater risk:
- Being overweight or obese.
- Diet high in meat, seafood and beverages with fructose.
- Alcohol consumption, particularly beer drinking.
- Family history of gout.
- Men over the age of 30 years.
- Certain medication like some diuretics used for treating high blood pressure, aspirin and drugs for organ transplant patients.
- Some medical conditions such as kidney disease, diabetes, metabolic syndrome and heart disease.
Attacks of Toe Pain
Gout pain typically occurs as attacks and mainly affects the toes. The pain intensifies within the first 4 to 12 hours of the attack and continues thereafter for hours and days but tends to be less severe. While the joints of the toes and particularly the big toes is the most commonly affected site, gouty arthritis can also affect other joints such as those in the hands, wrists, knees and ankles.
Tenderness of Joints
Joint tenderness is another signs of gouty arthritis where even the slightest pressure may exacerbate the pain. Most people cannot wear closed shows during these attacks and even socks or a bedsheet touching the affect joint worsens the pain. Depending on the joint that is affected, standing and walking may be difficult and extremely painful. It is understandably more severe in people who are overweight or obese due to greater pressure on the joint.
Another common sign of gout is that there is a persistent discomfort in the joint for days and even weeks after an attack. Initially the pain starts suddenly, reaches a peak and the gradually subsides. However, there is lingering discomfort which may also be described as an ache. Sometimes gout sufferers descibe a sensation of pressure on the affected joint that continues for long periods even without an attack. It may also be a prelude to the onset of an attack.
Swollen, Warm and Red Joints
Attacks of gouty arthritis is an acute inflammatory reactions. Apart from pain, the other features of inflammation are also present and quite pronounced. This includes swelling of the joint with redness of the overlying skin and heat from the affected area. The swelling, redness and warmth usually correlate with the severity of the pain and tenderness seen during attacks.
Reduced Range of Motion
The range of motion at the affected joint is usually reduced. Apart from the swelling that may impair normal movement, the exacerbation of pain also limits a person ability to move the area. This can affect a host of daily activities depending on which joints are affected. A person may be unable to stand or walk, move the hands for certain activities, put on clothing without assistance or even feed and bathe themselves properly.
How To Prevent and Relieve Gout Attacks
There are several drugs that are effective both for the prevention and treatment of gout. However, dietary and lifestyle measures can also be effective in preventing attacks and managing gout. This includes:
- Reduce the intake of foods and beverages that increase uric acid levels. This includes meat especially offals, seafood and fructose-sweetened drinks.
- Alcohol intake should be avoided as far as possible or at the very least minimized. It increases uric acid levels while reducing the fluid volume in the bloodstream.
- Drink plenty of water to assist the body with flushing out uric acid in the bloodstream. Patients with kidney disease and on certain drugs should first speak to a doctor about the acceptable daily water intake.
- Maintain a healthy body weight by changing dietary habits and exercising regularly. Gout is not caused by exercise but physical activity can worsen the pain during an attack.
- Vitamin C has been shown to reduce uric acid levels but this does not necessarily mean that it will reduce the frequency and severity of attacks. Do not take large doses of vitamin C unless advised by a doctor.
- Coffee has also been show to reduce uric acid levels but there has been no direct correlation with gouty arthritis attacks. However, caffeine can dehydrate the body so water consumption must be increased accordingly.
Read more on gout diet and lifestyle tips.