Gout

What You Can Do About Gout

This painful type of arthritis was traditionally known as a condition that affected men who drank too much and had bad dietary habits. Gout has always been unfashionable due to being plagued by these stereotypes, however there’s a lot more to gout than meets the eye. For a comprehensive look at this common condition we’ve put together a guide to help you understand the symptoms, get a diagnosis, plan your treatment and manage your lifestyle to give you everything you need to tackle gout.

What is Gout?

Gout is a form of arthritis that causes a very quick onset of pain and difficulty in movement in the joints. It’s very common in the knees, hands and feet. Whilst it certainly affects more men than women, anyone can get it, usually striking after puberty or after the menopause in women. It all starts with a chemical known as Uric Acid. This substance can be found in our diet or when our old cells break down, and it collects in the blood as a type of salt called Urate. A build-up of this causes urate crystals to form; which in turn collect at the joints, under the skin or even in the kidneys, causing kidney stones.

What am I Looking For?

The main symptoms can appear to be other forms of arthritis, the difference being Gout comes on very quickly and severely:

  • Pain: The pain is sudden and severe, appearing in the joints usually at night or early morning.
  • Skin Sensitivity: The area around the joint turns red and is hot, swollen and irritated. The lightest touch could be painful, and you may experience skin peeling.

These symptoms often last for a few days but can be debilitating. Once you have had one episode of Gout, you are more likely to experience it again, so it’s important to see a medical professional as soon as you have these symptoms to reduce your chances of having them again.

Gout can also be a precursor to another, underlying condition you might have. This could be anything from angina, high blood pressure, psoriasis, kidney disease or diabetes.

Why Do I Have Gout?

Unlike the stereotypical gout candidate, there are many reasons why you might be experiencing this condition:

  • High Urate Levels: Most people with Gout have high urate levels in their blood, and do not pass enough of this in their urine. This could be because of an abnormality in the amount of uric acid the body produces, or because of lifestyle; diet, stress, illness, medications.
  • Genetics: Latest research shows that 1 in 10 people with Gout have a family history of the condition.
  • Age: Unfortunately, as we age, we become prone to more conditions, and Gout is no exception. After the menopause it’s more common in women, and for older men in general.
  • Obesity: There is some truth in the age-old stereotype. Those who are overweight and who drink excessive units of alcohol are more at risk of developing Gout.

How Do I Get a Diagnosis?

As we said before, it’s important to get in touch with your doctor if you think you are experiencing symptoms of Gout. This isn’t just to get a diagnosis, but to rule out other conditions that might be causing your symptoms.

A sudden onset of pain and swelling in a joint will need to be examined by a doctor. They will likely take a full medical history, before commencing a physical examination. They may also perform blood tests and X-rays or other scans to look at the joint more closely.

Additionally, they might wish to aspirate fluid from the joint in order to look at the contents. If there are high levels of urate crystals, then a diagnosis of Gout will be made. However, if they find bacteria in the fluid, this could be a sign of infection which will need treatment with antibiotics.

An acute, or initial attack of Gout can be dealt with by a general doctor, however repeat or severe episodes will warrant a referral to a Gout specialist, also known as a Rheumatologist.

How is Gout Treated?

Treating an attack of Gout is just one-step in the process of managing this condition.

Step One

Your doctor will prescribe medication to take for a few days until the symptoms have passed. These could be anti-inflammatories, such as Ibuprofen, Corticosteroids to reduce the pain and swelling and a medication called Colchicine. These are all most effective taken within 24 hours of your symptoms starting. If you are experiencing severe symptoms, there is also an option to have an injection of steroids if they are prolonged.

At home, you should elevate the affected joint and keep it cold with ice packs. Additionally, you should drink lots of fluids such as water and juices – avoid alcohol and carbonated, sugary beverages. Relaxation can also help, so try to reduce the stressors in your life as much as possible. It may also help to keep coverings off the affected joint.

Step Two

If you are found to have elevated levels of uric acid in your body, your doctor will likely prescribe medication to reduce this. As with all drug treatments, there can be side effects and your doctor will be able to discuss these in greater detail. These will need to be taken regularly, even when you’re not experiencing symptoms. Some common medications used in this way include:

Allopurinol / Febuxostat – Tablet form

Probenecid – Tablet Form

Pegloticase – IV Injection. For cases that do not resolve with the previous medications.

Step Three

Lifestyle changes are usually recommended to Gout sufferers to reduce the risk of further attacks. If you are overweight, a gradual weight-loss plan may be necessary. You’ll be advised to cut down on rich foods and drink that cause uric acid build-up. This will involve cutting down your alcohol and sugary drink consumption, reducing how much red meat, seafood and fatty foods you eat and trying to adopt a more balanced diet. Fresh fruit and vegetables, water and low-fat dairy foods will all help. It is also advisable to stop smoking or cut down as much as possible.

How Do I Live with Gout?

The bad news is, most Gout cases come from the way we live. From stress to our diets and exercise regime, they all play a part in how our body copes with daily life.

Stress is a big factor in a lot of arthritic conditions, so learning techniques to reduce this will have a great impact in your health. Study mindfulness strategies, such as meditation and try to stretch and unwind before bed and in the morning.

A balanced diet will help with your overall health. If you’ve been wanting to lose weight, take Gout as a sign that you should start. Losing weight will keep you healthy and also reduce the strain on your joints. Eat regularly and don’t overindulge. Drink alcohol on scheduled days and keep track of your intake. Keep hydrated and plan your meals.

You do not have to become an Olympian, but regular, gentle exercise will help. Exercise keeps up physically and mentally healthy. If you need advice on what to start with, your doctor will be able to provide some guidance on exercises that could be tailored to your specific needs.

In Conclusion

Gout is a very common form of arthritis that benefits from early diagnosis and treatment. Ultimately, repeat attacks are likely but can be reduced through a dedicated treatment plan and lifestyle changes. There are many resources available in your area to help, alongside support networks on the internet.

References

https://www.arthritis.org/diseases/gout

http://www.ukgoutsociety.org/all_about_gout.htm

https://www.nhs.uk/conditions/gout/

Other conditions

Rheumatoid Arthritis (RA)

Read More

Psoriatic Arthritis

Read More

Fibromyalgia

Read More

Juvenile Idiopathic Arthritis (JIA)

Read More

Osteoarthritis

Read More