What is Gout? What is Good for Gout?

Gout , also known as the disease of kings or the disease of the rich, is a severe rheumatic disease that led to the death of sultans. Although gout, also called gout disease, is in the category of rheumatic diseases, it can be considered a metabolic disease. The disease, which is more common in men, can negatively affect a persons work and social life.

Gout is a term used to refer to various conditions characterized by uric acid accumulation. This accumulation usually occurs on a persons feet. People with gout may feel edema and pain in their foot joints. The big toe is one of the joints most affected by this disorder. A gout attack causes sudden and sharp pain and people may feel as if their feet are burning. Although the symptoms of gout are temporary, there are various methods to control the symptoms.

What is Gout?

Gout, a chronic (long-term) and common joint inflammation, is a disorder characterized by the accumulation of monohydrate crystals called monosodium urate in the tissues. Gout, whose history dates back to ancient times, is a rheumatological disease that has been studied in detail and can be controlled.

Under normal conditions, waste materials in the body, especially protein wastes, are converted into uric acid and removed from the body. Problems in excreting uric acid or producing too much of these substances may result in accumulation in the blood and body. When the amount of uric acid in the bloodstream exceeds normal, it is called hyperuricemia. This condition can progress to gout over time and result in very painful joint inflammation.

Hyperuricemia also causes urine and blood to become highly acidic. Some meats, alcoholic beverages such as beer, geraniums and dried legumes are among the foods with high uric acid levels. Apart from diet, genetic factors, being overweight or obesity, and stress are among the factors associated with increased uric acid levels in the blood.

Uric acid, which is found in excessive amounts in the blood, leaks from the tissue gaps and accumulates in the joint and surrounding structures. Accumulation in the joints can cause inflammation in these areas, leading to increased fluid in the joints, movement restrictions and pain. This disorder, which particularly affects the big toe and knee joints, is called gout. Sometimes uric acid can also accumulate in the kidneys. Care should be taken as this may result in kidney stone formation.

What are the Stages of Gout Disease?

Gout disease progresses in 4 stages: acute attack, intercritical period, chronic gout and tophus gout.

• Acute Attack: It is the phase of the disease that begins suddenly in the joint and lasts 5-10 days. Short-term swelling and pain are observed in the joints.

• Intercritical Period: This is the phase in which the patients complaints completely disappear. However, severe attacks may occur again immediately after this phase.
• Chronic Gout: If the time between attacks gradually shortens and is not treated, permanent swelling, pain and limitation of movement may occur in one or more joints.
• Tophus Gout: As the disease progresses, uric acid accumulates excessively in the joints and surrounding tissues and forms swellings called tophi. Tophi occur especially on the big toe, metatarsal bone, on the top of the fingers and near the elbows.

What are the symptoms of gout disease?

As a result of the accumulation of acid ions in the body in the morning, swelling occurs in the joints and severe pain occurs. In fact, the pain is so severe that the patient wakes up from his sleep. Gout is a disease caused by the accumulation of uric acid in the kidneys. In addition to symptoms such as blood in the urine and stones, abdominal and lower back pain may be experienced. Pain becomes chronic and uric acid accumulated in the joints can cause constant swelling of the joints and cause deformations.

Gout is generally considered an inflammation of the joints (arthritis). The onset of attacks is sudden and painful. A variety of symptoms may occur in the affected joint area, including burning, stiffness, and swelling. Symptoms of gout may vary from person to person. It may even follow an asymptomatic course in some people. While these people are found to have increased uric acid levels in the blood, there are no complaints about gout. The symptoms that occur during attacks are called acute gout symptoms. Pain, redness and edema are the main symptoms of a gout attack. Especially after attacks that start at night, people may wake up from their sleep due to the symptoms. Even very minor contacts to the affected area can cause unbearable complaints. At the same time, there is a limitation in the movements of the affected joint.

Complaints occurring in an acute gout attack typically occur in a single joint. The big toe is the most commonly affected joint area. Although the duration of complaints usually varies between 12-24 hours, there are also severe gout cases in which symptoms continue for 10 days. Patients continue their lives without any complaints during the period between acute gout attacks.

Recurrent attacks of acute gout can cause permanent damage to joints. In addition to joint pain, symptoms such as inflammation, redness, edema and mobility problems improve over time, while symptoms such as peeling and itching of the skin of the affected area may occur. In this disease, which can affect other joints of the body besides the big toe, wrist joints, fingers, elbow, heel and the upper part of the foot are among the other areas that can be affected by gout.

If gout attacks occur more frequently than normal, this is called chronic gout disease. Care should be taken as chronic gout attacks can lead to serious health problems if not treated appropriately. In chronic gout patients, the pain may become constant, and in this case, the persons sleep quality is negatively affected. Problems such as fatigue, increased stress and mood changes may occur as a result of insomnia. Apart from sleep quality, walking, doing housework, and various other normal daily activities can also be negatively affected.

Tophi is a chronic gout complaint characterized by the accumulation of uric acid crystals under the skin. Tophus, which can occur in the hands, feet, wrists and ears, appear as hard subcutaneous swellings that are not painful but become inflamed and edematous during the attack. As the tophus continues to grow, it can damage surrounding skin and joint tissues. It is very important to receive appropriate treatment as joint deformities may occur as this condition progresses.

Uric acid, which is found in high amounts in the blood, can accumulate in the lungs as well as the kidneys. Apart from this very rare condition, it is recommended to be careful as different health problems such as cataracts and dry eye syndrome may occur in chronic gout patients.

What Causes Gout?

The most important cause of gout is the bodys excessive production of uric acid or the inability to excrete the produced uric acid through the kidneys. Unhealthy eating habits, excessive alcohol consumption, sudden and severe diseases, various drug treatments, joint traumas, surgical operations and kidney diseases are among the situations that can cause an increase in the amount of uric acid in the blood. Increasing age may also increase the risk of developing gout. Gout is a disorder that may run in families in some people. Dozens of different genes, especially the SLC2A9 and ABCG2 genes, may predispose to gout. Genes associated with gout are associated with uric acid metabolism.

It is accepted that genetic factors may be effective in the formation of gout, and in addition to familial factors, some diseases may also have a facilitating effect. Obesity, diabetes, heart disease, high blood pressure and high cholesterol are among the diseases in which the risk of gout is higher in patients.

During the course of some disorders, an increase in uric acid production in the body may occur. This condition, which is associated with abnormal enzyme activities, usually occurs in conditions such as lymphoma, leukemia, hemolytic anemia and psoriasis. An increase in uric acid production may occur as a side effect after chemotherapy and radiotherapy used in the treatment of cancer patients.

How is Gout Disease Diagnosed?

Detection of monosodium urate crystals in synovial fluid (fluid in the joint space) analysis is the gold standard diagnostic method for gout. In this examination, physicians take a fluid sample from the affected joint area with a thin needle. Synovial fluid becomes yellow and cloudy during acute gout flares. Microscopic examination of this fluid, which also contains crystals and white blood cells, differentiates it from joint inflammation caused by microbial factors.

Various laboratory studies can also be used in the diagnostic approach to gout. Although biochemical markers such as white blood cell count, erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) are useful in acute gout, it should not be forgotten that they are not specific for this disease. Although measuring uric acid level through blood tests is a very important test, they can sometimes lead to misdirection. It should be kept in mind that while some people have high blood uric acid levels but do not have symptoms of gout, some people may have gout symptoms even though their blood uric acid levels are low. For these reasons, although measurement of blood uric acid level alone is not considered sufficient for the diagnosis of gout, it can be used to examine the course of gout in some patients.

In addition to biochemical tests, various imaging studies can be used to diagnose gout. Although not routinely performed, ultrasonography can detect crystals accumulated in the cartilage area. X-ray radiographs are among the radiological diagnostic tools that can be useful in differentiating gout from some other joint disorders.

How is Gout Disease Treated?

In gout, separate treatment methods are applied during acute attacks and in the periods between attacks. While anti-inflammatory drugs are used in acute periods when pain is intense, the drugs used in drug treatment can be changed by physicians depending on the course of the disease. Non-steroidal anti-inflammatory drugs, colchicine or corticosteroids are among the drugs that can be used in the treatment of gout, depending on the persons condition. Medicines containing the active ingredient colchicine are anti-inflammatory drugs that are considered effective in controlling the pain caused by gout.

In some patients, gout flares can have a very severe and chronic course. In order to prevent kidney stones, tophus or other gout-related complications that may occur in these people, medications that reduce uric acid production in the body or increase uric acid excretion in the urine may be used. It is very important that the use of these drugs, which may cause side effects such as fever, skin rash, liver inflammation or kidney problems, is carried out under the supervision of a doctor.

Since physical activity may increase the severity of attacks, patients are recommended to rest during the acute period. Diet therapy plays as important a role as medication in gout. For the treatment of gout, patients are recommended to follow a special diet prepared by a dietician, consume plenty of water and improve their quality of life with light exercise programs.

Gout Disease Diet

Preparing a personalized nutrition program suitable for gout is one of the most important steps that can be taken to reduce the number of exacerbations. This diet aims to reduce the blood uric acid level to normal limits.

Restricting or completely cutting out alcohol intake, especially beer consumption, is an important lifestyle change in improving gout symptoms. In addition, increasing fluid consumption, choosing low-fat dairy products, avoiding consumption of organ meats or fatty small fish with high purine content, choosing legumes as a protein source, and consuming whole wheat products or fresh vegetables and fruits for carbohydrate consumption are included in the diet plan. It is among other possible applications.

Foods with low purine content in the diet are defined as foods containing less than 100 milligrams of purine per 100 grams. All fruits are among the foods that do not pose a problem for gout. Cherry fruit can support the bodys normal functions in preventing gout attacks due to its contribution to uric acid levels and inflammation levels. All vegetable products, including potatoes, peas, mushrooms, eggplants and green leafy vegetables, are among the foods that can be consumed by gout patients. In addition to fruits and vegetables, eggs, dairy products, nuts, coffee, tea and green tea, spices and vegetable oils are foods that can be included in the nutrition plan of gout patients.

Reducing Body Weight

Excess weight may be a risk factor for gout attacks. Insulin resistance, which occurs especially in overweight people, is a condition considered to be associated with high blood uric acid levels. With weight loss, people can both break the resistance to the insulin hormone and contribute to lower uric acid levels.

The thing that gout patients should pay attention to when it comes to losing weight is the speed of weight loss. Care should be taken as rapid weight loss on a very low-calorie diet may increase the risk of developing a gout attack.

To exercise

Regular exercise is another practice that can be done to prevent attacks of gout and can contribute to lowering uric acid levels.

Adequate Fluid Consumption

Ensuring adequate daily fluid consumption may reduce the risk of developing a gout attack. With fluid intake, the excretion of extra uric acid in the bloodstream from the kidneys becomes easier and is removed with urine. Fluid consumption is an issue that should not be neglected, especially by people who exercise regularly, who lose some of their body fluids through sweating.

Limiting Alcohol Consumption

Alcohol is a known trigger for gout. The reason for this situation is that the body prioritizes excretion of alcohol rather than removing excess uric acid from the body with alcohol consumption. Thus, it becomes easier for uric acid, which remains in high amounts after alcohol consumption, to accumulate and turn into crystal form.

Diet, exercise and other lifestyle changes are very effective in treating gout and other health conditions caused by high uric acid. In some people, medical treatment may be necessary in addition to lifestyle changes. Strictly adhering to the medications prescribed by physicians is an important part of the treatment.

If you notice the symptoms of gout, which is a type of joint inflammation, in yourself or those around you, it is recommended that you contact healthcare institutions and get help from specialist physicians about appropriate treatment and lifestyle changes.

We wish you healthy days.