What Is Gout Arthritis?
Gout arthritis is a form of inflammatory arthritis that occurs in individuals with high blood uric acid levels. This uric acid can form needle-like crystals in the joints.
As a result, this condition can cause very painful gout attacks, accompanied by redness, swelling, and warmth in the area.
Symptoms of Gout Arthritis
Symptoms of gouty arthritis include:
- Sudden, severe pain in the joints, usually in the middle of the night or early in the morning.
- Pain in the joints. The pain may feel warm to the touch and may appear red or purple.
- Stiffness in the joints causes limited movement.
- The most commonly affected joints are the big toe, ankle, knee, elbow, wrist, and fingers.
If gouty arthritis is left untreated for a long time, crystals can form lumps under the skin around the joints.
They are called tophi. They are not painful, but they can affect the way joints look. If crystals build up in the urinary tract, they can form kidney stones.
There are several stages of gouty arthritis and different symptoms at each stage:
- Asymptomatic hyperuricemia is the period before the first gout attack. There are no symptoms, but blood uric acid levels are high and crystals begin to form in the joints.
- Acute gouty arthritis or a gout attack occurs when something (such as eating or drinking) causes uric acid levels to spike and cause crystals that have formed in the joint to be crushed, triggering an attack. The resulting inflammation and pain usually strike at night and last for the next eight to 12 hours. Symptoms subside after a few days and may resolve within a week to 10 days. Some people never have a second attack, but an estimated 60 percent of people who have a gout attack will have a second attack within a year. Overall, 84 percent may have another attack within three years.
- Interval gouty arthritis is the time between attacks. Although there is no pain, gout does not disappear. Inflammation, although at a low level, can damage the joints. When someone has interval gouty arthritis, then changing your lifestyle and undergoing appropriate treatment can be done to manage gout. In addition, to prevent future attacks or the occurrence of chronic gout.
- Chronic gouty arthritis develops in people with gout whose uric acid levels remain high for many years. Attacks become more frequent and pain may not go away as it once did. Joint damage can occur, leading to loss of mobility. With proper management and treatment, you can prevent this stage.
Causes of Gout Arthritis
Gouty arthritis occurs when urate crystals build up in the joints, causing inflammation and intense pain from a gout attack. Urate crystals can form when a person has high levels of uric acid in the blood.
The body produces uric acid when it breaks down purines, substances found naturally in the body. Purines can also be found in certain foods, such as steak, organ meats, and seafood.
Other foods also promote higher uric acid levels, such as alcoholic beverages, especially beer, and drinks that have added sweeteners such as fruit sugar (fructose).
Normally, uric acid dissolves in the blood and passes through the kidneys into the urine. However, sometimes the body produces too much uric acid or the kidneys excrete too little uric acid.
When this happens, uric acid can build up, forming sharp, pinpoint, urate-like crystals in or around the joint tissue causing pain, inflammation, and swelling.
Risk Factors for Gout Arthritis
Gout arthritis has several risk factors, including:
- Genetics: If a family member has gout, it’s likely that someone in the family will get it too.
- Other health conditions: High cholesterol, high blood pressure, diabetes, and heart disease can increase the risk of developing this disease.
- Medications: Diuretics taken for high blood pressure can increase uric acid levels; as can some drugs that suppress the immune system used by people with rheumatoid arthritis, psoriasis, and transplant recipients.
- Gender and age: Gout is more common in men than women (until about age 60). Experts believe that natural estrogen protects women up to that point.
- Diet: Eating red meat and shellfish increases the risk.
- Alcohol: For most people, drinking more than two drinks a day can increase the risk of gout.
- Soda: The fructose in sugary soda has recently been shown to increase the risk of gout.
- Obesity: Obese people have a higher risk of gout and tend to develop it at a younger age than people of normal weight.
- Bypass Surgery: Those who have undergone gastric bypass surgery have an increased risk of gout.
Diagnosis of Gout Arthritis
In addition to interviews and examinations to explore the history of complaints and also find typical signs and symptoms, doctors can also perform several supporting tests.
This test helps doctors know if someone has gout or something else with similar symptoms:
- Joint fluid test. Fluid is taken from the affected joint with a needle and studied under a microscope to check for crystals.
- Blood test. A blood test can check uric acid levels. High uric acid levels do not necessarily mean gout, but they do mean there is a risk of getting gout.
- X-ray. Images of the joint will help rule out other problems.
- Ultrasound. This painless test uses sound waves to look at the area of gout.
Gout Arthritis Treatment
Medications to Treat Gout Arthritis Attacks
Medications used to treat acute attacks and prevent future attacks include:
- Non-steroidal anti-inflammatory drugs (NSAIDs).
- Your doctor may prescribe a higher dose to stop an acute attack followed by a lower daily dose to prevent future attacks.
- NSAIDs carry a risk of stomach upset, bleeding, and stomach ulcers.
- Effective pain relievers reduce gout pain. The effectiveness of the drug may be offset, however, by side effects, such as nausea, vomiting, and diarrhea, especially when taken in large doses.
- After an acute gout attack resolves, your doctor may prescribe a daily low-dose medication to prevent future attacks.
- Corticosteroids. Corticosteroid medications can control the inflammation and pain of gout. Corticosteroids can be in pill form or can be injected into the joint by a doctor.
- Corticosteroids are generally only used by doctors in people with gout who cannot take NSAIDs. Side effects of corticosteroids may include mood changes, increased blood sugar levels, and increased blood pressure.
Medications to Prevent Gout Arthritis Complications
If you have several gout attacks each year or your gout attacks are not very frequent but are very painful, your doctor may recommend medications to reduce the risk of gout-related complications.
If you have evidence of gouty arthritis damage on joint X-rays or have tophi, chronic kidney disease or kidney stones, your doctor may recommend medication to lower your body’s uric acid levels.
Options include:
- Medications that block the production of uric acid. Taking these medications can lower blood uric acid levels and reduce the risk of gout. Side effects include rashes and low blood counts.
- A drug that increases the elimination of uric acid. Side effects include rash, upset stomach, and kidney stones.
Prevention of Gout Arthritis
During asymptomatic periods, these dietary guidelines may help protect against future attacks of gouty arthritis:
- Drink plenty of fluids. Keep your body well hydrated by drinking plenty of water. Limit how many sugary drinks you drink, especially those with sweeteners like high fructose corn syrup.
- Limit or avoid alcohol. Talk to your doctor about what amount or type of alcohol is safe for you to drink. Studies have shown that the risk of gout symptoms may be increased by excessive beer consumption, especially in men.
- Get your protein from low-fat dairy products. Low-fat dairy products actually have a protective effect against gout and are the best source of protein.
- Limit your intake of meat, fish, and poultry. Small amounts may be tolerated, but be aware of what types and how much are causing health problems.
- Maintain a healthy weight . Choose portions that allow you to maintain a healthy weight. Losing weight can lower uric acid levels in the body. However, avoid rapid or rapid weight loss as it can temporarily increase uric acid levels.