Gout: Symptoms, Treatment + Prevention
What is Gout?
Gout is a condition in which an excess of uric acid causes inflammation, swelling, and pain in the joints. Gout typically occurs in flare-ups lasting 7-14 days, with several weeks, months, or even years in between attacks. An estimated 8.1 million adults are affected by gout in the US alone.
Who is at Greatest Risk for Gout?
Gout is more than twice as common in men than in women. According to the Center for Disease Control (CDC), 2.2 million women are affected by gout as compared to 5.9 million men. Gout development can also be influenced by race, with black men twice as likely to have gout than white men. In addition to sex and race, obesity, hypertension, excess alcohol consumption, diuretic use, and poor kidney function can all increase the risk of gout.
Acute Gout vs. Chronic Gout
Acute gout causes swelling, inflammation and pain in one or more joints of the body, but goes away with proper treatment and does not reoccur with proper health maintenance. Chronic gout occurs in alternating episodes of flares and remission and often affects multiple joints at a time. People suffering from chronic gout may also experience chronic arthritis and tophi (deposits or urate crystals in soft tissue across the body). Most patients with chronic gout require a long-term treatment plan that aims to lessen the severity and frequency of flare-ups.
Could I Have Gout?
Because it also causes swelling, inflammation, and pain in the joints, gout can easily be mistaken for arthritis. However, there are several key differences between the presentation of gout and arthritis. Attacks of joint pain and swelling are likely to be gout if the inflammation arises in a single day and if it occurs in only one joint (popularly the big toe, ankle, or knee). Gout can also be detected in a doctor’s office through blood and joint fluid tests that check for high levels of uric acid associated with gout.
When Gout Progresses
Gout progression is separated into four stages: Asymptomatic (without symptoms) hyperuricemia, in this stage, a person has elevated levels of uric acid in the blood (hyperuricemia), but no physical symptoms of gout. Acute gout, characterized by flares when high levels of uric acid crystallize in the joints and cause swelling or inflammation that subsides with several days of treatment. Acute flares are separated by periods of intercritical segments in which there are no physical symptoms of gout but high levels of uric acid still exist in the body. Chronic gout is the final stage of gout when acute attacks occur more or less regularly and cause significant swelling and pain in one or more joints. In advanced cases of chronic gout, permanent damage to the kidneys and joints may occur.
Obesity and Gout
Obesity and its associated conditions (high blood pressure, high cholesterol, diabetes) increase the risk of developing gout. Obese patients are also more likely to develop gout at a younger age. A study of 517 gout patients found that those that were obese at the start of the study developed the disease an average of 31 years earlier than those that were not obese. The same study also found that the impact of obesity on gout risk is even greater for patients who are obese by the age of 21.
The Truth About High Fructose Corn Syrup
A 2010 article published by arthritiscare.com states that excess sugar in the body disturbs the body’s normal metabolic processes and leads to the production of excess uric acid, greatly increasing the risk of gout. High fructose corn syrup is made from fructose; a simpler sugar molecule than sucrose (table sugar), and it therefore metabolizes more quickly and is likely to cause high blood sugar and metabolic disturbance, making it especially dangerous to those at risk of developing gout. The debate over the healthiness of high fructose corn syrup continues to be a controversial topic.
Diabetes and Gout
Diabetes is one of the most prominent risk factors for gout. Diabetics are more likely to have irregular blood sugar levels, which can lead to the production of excess uric acid, therefore increasing the risk of gout. Diabetics also commonly have poor circulation, which makes it easier for uric acid to crystallize and form deposits in joints and soft tissue. Having gout can also put you at risk for diabetes, since the two conditions are so closely related.
Managing Chronic Gout
To prevent the progression of gout to permanent joint and kidney damage and to decrease the frequency and severity of gout flare-ups, doctors often prescribe long-term medications in combination with short-term pain relief and lifestyle changes. Long-term medications prescribed to help manage chronic gout include allopurinol, febuxostat, probenecid, and pegloticase. Talk to your doctor about which chronic gout management plan is best for you.
An Alternative Cure for Gout?
Though everybody has different reasons for gout flare-ups, dehydration, excess heat, and alcohol consumption are all known triggers. Drink 6-8 glasses of water each day, monitor your body temperature, and limit your alcohol consumption. To find out what things trigger your gout attacks, consider keeping a journal to keep track of potentially triggering foods, activities, and emotions.
Avoiding Flare-ups: What Not to Do
Several studies have found that gout attacks happen less frequently in patients that regularly exercise. Regular exercise is an important part of managing chronic gout in that it helps regulate metabolism, increase circulation, and decrease inflammation in the body. However, excessive exercise without proper hydration can cause dehydration, put stress on the kidneys, and increase the risk of inflammation.
