What is it?
Gout is a disease caused by the accumulation of microscopic uric acid crystals in the joints that cause arthritis.
Sometimes these crystals form bulky accumulations (tophi) under the skin that can be palpated or deposited in the urinary tract, causing nephritic colic or other disturbances in the functioning of these organs. In fact, almost 20 percent of gout-affected patients develop kidney stones.
By sex, gout is 4 times more common in men, especially among middle-aged men, although it also occurs in women after menopause.
- The reasons why this disease develops can be:
- Uric acid increases in the blood.
- Excessive intake of uric acid precursor foods: seafood, for example.
- Alcohol abuse.
- To a lesser extent, tiredness and emotional stress.
The constant destruction and formation of cells, as well as the intake of certain foods produce a certain amount of uric acid in the blood that the body eliminates thanks to the excretory function of the kidneys. When this does not happen, the level of uric acid increases abnormally, which is translated in the form of crystals that are deposited in the joints, leading to episodes of acute pain.
Signs of acute gout include:
Initially, only one or a few joints are affected. These are most often those of the big toe, knee, or ankle.
This gout attack may go away within a few days but may come back from time to time.
Generally speaking, pain usually occurs at night and is characterized by being oppressive and even excruciating.
The affected joint is hot and red (inflamed) and is usually tender and swollen.
Fever may occur.
After the first gout attack, symptoms usually disappear as well, but many people with gout may have another attack within 6 to 12 months.
On the other hand, some people can develop chronic gout, which is called gouty arthritis. As for its symptoms, there is joint damage and loss of mobility in these joints and they will be more prolonged in time than the symptoms of acute gout.
Lastly, tophi (bumps under the skin around the joints or in places like the elbows, fingertips, or ears) can develop that sometimes ooze whitish substances, but only in those patients who have had the disease for many years.
The disease may not be preventable, although the factors that trigger the symptoms can be avoided.
Taking medicines to reduce uric acid can prevent the evolution of this disease. It is advisable to drink plenty of liquids (avoiding alcoholic beverages) and eat a diet rich in cereals, starches and vegetables compared to the purines that can be found in seafood, red meat and blue fish. A low daily dose of colchicine can prevent attacks or at least reduce their frequency.
For people with very high levels of uric acid in the blood, allopurinol (an inhibitor of uric acid production) may be the solution, although it can also cause stomach discomfort and liver damage.
The tophi, if any, are usually reduced as the uric acid value in the blood decreases, but it may be necessary to remove them surgically if they are excessively large.
The classification of this disease is summarized in three types:
Acute: A painful condition that normally affects a single joint.
Chronic: When episodes of pain are repetitive and cause inflammation. In this case, more than one joint is usually affected.
Pseudo gout: Calcium pyrophosphate dehydrate crystal deposition disease. It is a disorder characterized by intermittent attacks of pain and arthritis, caused by the accumulation of these crystals.
To diagnose the disease, the specialist will ask about the symptoms and if the patient has a family history of gout.
In addition, tests to determine uric acid levels in the blood should be performed, if the joint fluid contains crystals of that acid (the specialist will take a sample of fluid from an inflamed joint) and a thorough monitoring of the patients will be carried out who have arthritis episodes discontinuously.