Gout. It’s a term many of us have heard, but I would guess not many of us understand. We know it isn’t good and that it’s painful. Beyond that, many of us are in the dark as to what it is and what causes it. Why should you worry about gout? Well, statistically speaking African Americans are more likely to suffer from gout than any other racial group. This is due to the higher prevalence of risk factors including obesity, diabetes, chronic kidney disease, and hypertension. However, men are more likely to develop the disease than women.
What is Gout and What Causes It?
Gout is a common form of arthritis that typically impacts one joint at a time. It usually starts in the big toe and can be extremely painful. And if left untreated can cause erosion of the joint, deformity, or even immobility. The condition is caused by hyperuricemia, which is a build up uric acid in the body. Uric acid is produced when the body breaks down purines. Purines are found naturally in the body and in certain foods. I won’t get into the chemical makeup of a purine, but foods that are heavy in purines include organ meats (liver, kidneys, brains, etc.), meats (bacon, beef, pork, and lamb), seafood, and beer. All of these foods can raise purine levels in the blood. The body excretes the uric acid through the urine. But when the body can’t evacuate the uric acid fast enough it becomes crystals that build up in joints, fluids, and other bodily tissues. Hyperuricemia doesn’t always lead to gout, but if you have certain risk factors it increases the probability.
Signs, Symptoms, and Risk Factors that Increase Chances for Gout
Once a blood test reveals high levels of uric acid the following risk factors will increase the probability of developing gout. Obesity plays a big role in the build up of uric acid because it can prevent the body from clearing it out. Drinking alcohol, especially beer, can raise the risk of developing gout. Of course, a diet high in purines will raise the levels of uric acid. Other factors include pre-existing health conditions such as hypertension, insulin resistance, metabolic syndrome, diabetes, and poor kidney function. Lastly, medications such as diuretics (water pills) will raise the risk because the body needs adequate hydration to clear uric acid from the body.
Aside from high uric acid levels other signs and symptoms of gout include intense pain in the joint, swelling, redness and a feeling of heat. A majority of the time the symptoms will first show in the big toe. A doctor can diagnose gout through a physical examination, X-rays, and lab tests. It can only be diagnosed during a flare when the joint is hot, swollen and painful and lab tests confirm hyperuricemia.
The Treatment for and Prevention of Gout
While there is no cure for gout, it is easily treated. Gout cycles through periods of flare when it’s painful and remission when it’s not. Medical and self-management are typically prescribed for gout. During a flare anti-inflammatory drugs (NSAIDs) such as Ibuprofen, steroids or colchicine are effective. When the joint goes into remission a flare can be prevented through lifestyle changes such as weight loss, diet, and exercise.
You can also prevent the development of hyperuricemia in the first place by exercising, limiting alcohol and purine-rich foods, and drinking plenty of water. Some research points to vitamin C as a way to help the body clear uric acid more effectively.
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