Gout – Symptoms, causes and other associated risk factors

Gout condition is characterized by severe and sudden attacks of redness, pain and tenderness in your joints and often is the joint at the base of your big toe. This condition is a complex form of arthritis and it can affect every single person. Men are having increased chances of getting this, but women are also having increased chances of getting gout after their menopause [1,2]. An attack can happen suddenly and often it can wake you up in the middle of the night with the sensation that your big toe is on fire. In this condition your affected joint is swollen, hot and so tender and even the weight of your sheet on it can seem intolerable. This condition is treatable and there are many ways which can help you to reduce the risk of having gout.

Symptoms of gout

The signs and symptoms of this condition almost always occur suddenly. They are usually happening at night and there is not warning. Here are the signs and symptoms of gout:

• Limited range of motion: Decreased joint mobility may occur as gout progresses.
• Redness and inflammation: The affected joints or joints become swollen, tender, warm and red.
• Lingering discomfort: After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. It is known that later attacks are likely to last longer and affect more joints.
• Intense joint pain: This condition usually affects the large joint of your big toe, but it can happen in your feet, hands, ankles, wrists and knees. This pain is likely to become more severe within the first 4 to 12 hours after it begins.

If you experience sudden and intense pain in your joint, then you should call your doctor. If you let this condition untreated, then it can lead to worsening pain and joint damage. You should seek medical help immediately if you have a fever and a joint is inflamed and hot because this can be a sign of infection.

Causes of Gout

This condition occurs when urate crystals accumulate in your joint which is causing intense pain and inflammation of a gout attack. Urate crystals can form when you have high levels of uric acid in the blood. It is known that our bodies are producing uric acid when it breaks down purines which are substances that are found naturally in our bodies, as well in some foods, such as seafood, organ meats and steak. Also there are other foods which also are promoting higher levels of uric acid such as drinks sweetened with fruit sugar (fructose) and alcoholic beverages, especially beer. Normally, the uric acid dissolves in your body and it passes through the kidneys into the urine. But there are some cases when our bodies are producing too much urine or our kidneys are excreting too little uric acid. When this is happening, then the uric acid build up, forming a sharp and needle like crystals in your joints or surrounding tissue which can cause swelling, inflammation and pain.

Risk factors: If you have high levels of uric acid in your body, then you have increased chances to have gout. Here are factors which increase the uric acid level in your body:

• Obesity: If you are overweight, then your body produces more uric acid and your kidneys have a more difficult time eliminating uric acid, which greatly increases your risk of gout. [3]
• Family history of gout: If other members of your family have had gout, then you are more likely to develop this disease. [4,5]
• Diet: Eating a diet which is high in meat and seafood and high in beverages sweetened with fruit sugar (fructose) promotes higher levels of uric acid, which increases your risk of gout. Also you have increased risk of getting gout if you consume alcohol, especially beer. [3]
• Certain medications: The use of thiazide diuretics – commonly used to treat hypertension – and low – dose aspirin also can increase uric acid levels. Also the use of anti – rejection drugs prescribed for people who have undergone an organ transplant can increase the risk of gout. [6]
• Medical conditions: Certain diseases and conditions make it more likely that you’ll develop gout. Medical conditions which lead to gout are untreated high blood pressure and chronic conditions such as diabetes, metabolic syndrome and heart and kidney diseases.

References:

[1] Jansen Dirken-Heukensfeldt KJM, Teunissen TAM, van de Lisdonk EH, Lagro-Janssen ALM. “Clinical features of women with gout arthritis.” A systematic review. Clinical Rheumatology. 2010;29(6):575–82.

[2] Bhole V, de Vera M, Rahman M, et al. Epidemiology of gout in women: Fifty-two–year followup of aprospective cohort. Arthritis & Rheumatism. 2010;62(4):1069-76.

[3] Lyu LC, Hsu CY, Yeh CY, et al. A case-control study of the association of diet and obesity with gout in Taiwan. The American Journal of Clinical Nutrition. 2003;78(4):690-701.

[4] Kuo CF, Grainge MJ, See LC, et al. Familial aggregation of gout and relative genetic and environmental contributions: a nationwide population study in Taiwan. Annals of the Rheumatic Diseases. 2015;74(2):369–74.

[5] University of Nottingham. New evidence that gout strongly runs in family. Science Daily. 2013.

[6] Igel TF, Krasnokutsky S, Pillinger MH. Recent advances in understanding and managing gout. F1000 Research. 2017;6:247.