A person may wake up in the middle of the night with the feeling that the thumb of the foot is on fire. They are hot, so swollen and delicate that the weight of the sheet becomes unbearable. These problems may indicate a severe attack of gout or gouty arthritis – a type of arthritis characterized by sudden episodes of severe pain, redness, and sensitivity in the joints. Gout is a complex disorder that can affect anyone, but men are more likely than women to develop gout, while women are particularly susceptible to gout, at menopause.
Fortunately, gout can be treated, and there are ways to reduce the risk of gout recurrence.
Symptoms of gout
Typically, gout symptoms appear sharply and suddenly, without prior warning, at frequent times during the night. It includes:
- Severe joint pain: Gout effects, in general, and mainly, the large joint in the thumb of the foot, but it may also affect other joints in the palm of the foot, ankles, knees, hands, and pelvis.
If gout is not treated, the pain may last between five to ten days and then disappear. The symptoms of gout diminish and the feeling of discomfort decreases gradually, over a period of one to two weeks, until the joint, at the end of this process, returns to its normal shape, the pain stops, and the symptoms of gout completely disappear.
- Inflammation and redness: the affected joint swells, turns red and becomes very sensitive.
Causes and risk factors of gout
Gout forms when crystals of uric acid build up around a joint, causing inflammation and severe pain – (a gout attack). And uric acid crystals form in people with high levels of uric acid in their blood.
The body produces uric acid as part of the process of breaking down purine, which is a substance naturally present in the body and in certain types of foods, such as internal organs, anchovy, herring, asparagus, and mushrooms.
Uric acid, in general, dissolves in the blood and travels through the kidneys into the urine. However, there are situations in which the body may produce very large amounts of uric acid, or the kidneys excrete very small amounts of uric acid. In these cases, uric acid builds up in the form of sharp (serrated), needle-like crystals inside the joint, or in the surrounding tissues, and as a result, pain, inflammation, and swelling develop.
Hence, people who have a high level (concentration) of uric acid in their bodies are more likely to develop gout.
Many factors may cause an increase in the level of uric acid in the body, including:
- Lifestyle factors: Drinking excessive amounts of alcoholic beverages
- Medical problems: hypertension (high blood pressure), diabetes, hypercholesterolemia, hyperlipidemia, and narrowing of the arteries (calcification/atherosclerosis).
- Certain drugs: Taking some medicines that contain thiazides – these are common for treating hypertension – and aspirin in small doses, may raise uric acid. The same applies to taking “anti-rejection drugs” that are taken by people who have undergone transplantation.
- Family history: a family history of gout.
- Age and gender: gout is more common among men than among women. Men are more likely to develop gout at a younger age than women – between the ages of 40-50 years, in general, while women have symptoms and signs of gout, often at “menopause”.
Complications of gout
More serious complications than gout itself can develop in people with gout, which can include:
- Recurrent gout.
- Advanced gout.
- Kidney stones.
Tests that help diagnose gout include:
- Examination of Synovia fluid in the joints.
- Blood test.
In general, treatment for gout is based on medication. These medications are decided by the physician, together with the patient, according to the patient’s health condition and preferences.
Medicines to treat gout include:
- Non-steroidal anti-inflammatory drugs (NSAIDs / NAIDs).
Prevention of gout
There are some things you can do to reduce the risk of additional attacks, and they include:
Your doctor may recommend that people who have gout attacks every year or people who have fewer but more painful attacks of gout, take medications that will reduce the risk of further attacks. And preventive drug treatment is started, in general, after the gout attack subsides and goes away.
Treatment options include:
- Medicines to prevent uric acid production.
- Medicines to improve uric acid secretion.
Feeding and gout
Certain dietary changes have not been shown to reduce the risk of developing gout. However, it makes sense to eat foods that contain the least amount of purine possible.
When trying the proper nutrition for gout, it is recommended to follow the following:
- Reduce your intake of red meat and seafood.
- Refrain from drinking alcoholic beverages.
- Increase your intake of low-fat milk products.
- Increase your intake of complex carbohydrates, such as whole-grain bread.
Attention should be paid to the need to consume quantities that ensure the maintenance of a healthy weight. Reducing weight may reduce the level of uric acid in the body. However, you should abstain from fasting and a rapid decrease in weight, because these things may cause a temporary increase in the concentration of uric acid.
If the treatment is not achieving the desired results, there is a possibility to try other complementary or alternative therapies for treating gout. And before starting to adopt these methods, you should consult your doctor about them. The physician can assess the preferences and risks and determine whether there is a risk that the alternative treatment will obstruct or interfere with the effectiveness of the drugs the patient is taking.
Some people have reservations about complementary and alternative treatments, but today many traditional doctors are showing great understanding and openness in the possibility of researching these therapeutic methods.
Since only a small fraction of these methods are tested in clinical studies, it is difficult to estimate their true efficacy in treating pain caused by gout. Also, in some cases, the risks involved with these treatments are not clear.
The complementary and alternative treatments for gout that have been researched include:
- Coffee: Researchers have found a relationship between coffee consumption, whether regular or decaffeinated and the presence of low levels of uric acid in the blood, although none of these studies was able to explain how coffee affects uric acid in the body. The available evidence is not sufficient proof to encourage people who do not drink coffee to start drinking it, but it has the potential to open new horizons for researchers to develop treatments for gout.
- Vitamin C: Vitamin C food additives may reduce the concentration of uric acid in the blood. However, there is not yet, there is no research examining the efficiency and effectiveness of this vitamin as a treatment for gout. It is a mistake to think that if small amounts of vitamin C are beneficial to the body, then large amounts of it will be more beneficial. An overdose of vitamin C may raise the concentration of uric acid in the body. Therefore, it is recommended that you consult your doctor about the appropriate amount of vitamin C. It is also important to remember that it is possible to increase the consumption of vitamin C by increasing the intake of vegetables, fruits, and citrus fruits, especially oranges.
- Cherry: Research has shown a relationship between eating cherries and a decrease in the concentration of uric acid in the blood, but it is not clear whether cherries have any effect on gout symptoms. Adding cherries and other dark fruits, such as blackberries (prickly berries), blueberries (cranberries), and purple grapes, to the menu may be a sure way to enrich and enhance gout treatment, but it is best to consult a doctor about this.
Other complementary and alternative therapies are also available that can help cope with the pain caused by gout, before it subsides, or before the drugs take effect. For example, some relaxation techniques, such as training in deep breathing and meditation – may help distract a person from pain.