Gout

Gout in fingers

Last Updated December 20th, 2021

Overview

Arthritic conditions were always common in the medical history of elderly patients. But these days, children and teens are also equally affected by different forms of arthritis. Research findings by the Arthritis Foundation of the United States show that more than 50 million people around the world are diagnosed with arthritis annually. Among them, nearly 3,00,000 infants and children have arthritic conditions.

The Third National Health and Nutrition Examination Survey by American College of Physicians has shown that the rate of occurrence of a particular form of arthritis, that is “gout”, is more than 2% in men above 30 years of age and in women above 50 years of age. According to the Rochester Epidemiology Project, cases of primary gout have doubled in the last 20 years. This undoubtedly had adverse socio-economic impacts. A detailed inspection of the dietary patterns and lifestyle trends of the present population is necessary to analyze the main causes behind the rise in the number of gout-affected patients worldwide.

 

What is Gout?

Gout vs normal feetGout is the most painful form of arthritis, characterized by acute inflammation of joints due to the accumulation of excess waste products and chemicals within the body, especially insoluble uric acid crystals. High levels of uric acid in blood for a long time lead to the formation of sharp, needle-like crystals within the tissues, causing pain and swelling of joints.

Gout attacks normally last for 1-2 weeks. But if left undiagnosed, conditions may become severe and the effect can persist for more than 3 weeks. Gout, in most cases, is characterized by Hyperuricemia, where the concentration of uric acid in the bloodstream is abnormally high. Very frequent gout attacks can damage the joints severely.

 

Which parts of the body are affected?

This disorder mainly affects the big toe. But it can occur in the following parts of the body as well-

  • Ankle
  • Heel
  • Instep
  • Wrist
  • Knee
  • Elbow
  • Fingers

In extreme cases, the uric acid crystals can cause a clustered growth of soft tissue masses called “tophi” which causes swollen and painful joints.

 

What Causes It?

Gout swollen jointsGout is mainly an inflammatory response to uric acid imbalance within the body. It is triggered by several biological factors which are described below:

  • Accumulation of excess uric acid within the body due to-
  • Failure of the kidney to pump out uric acid through urine
  • Excess intake of purine-rich foods (red meat, seafood)
  • Production of large volumes of uric acid within the body
  • Kidney diseases
  • Obesity
  • Excess alcohol consumption
  • The inability of body enzymes to break down purines drawn from food
  • Exposure to toxic chemicals such as lead
  • Organ transplant
  • Medications like diuretics, aspirin, and cyclosporine can interfere with uric acid excretion by the kidney
  • Excess intake of Vitamin B3 (niacin)
  • Drinking less water
  • Defective uric acid metabolism (often genetic)
  • History or existing conditions of hypertension, high blood pressure, high cholesterol or diabetes
  • Diseases like psoriasis and cancer (few types) that increase uric acid production
  • Reduction in the level of few essential hormones such as thyroid hormones (hypothyroidism) and estrogen (after menopause) which regulates uric acid level in the blood.

 

What Are The Symptoms Of This Condition?

Gout normally appears as inflammation in joints. Few additional symptoms are also observed in many cases-

  • Swollen (asymmetric), painful and reddish joints
  • Stiffness and immobility
  • Shooting pain accompanied by burning sensation
  • Tenderness and increased touch sensitivity
  • Peeled off skins from the affected area
  • Disfiguration of the affected area in advanced stages

In most cases, patients suffering from gout have a swollen, reddened and painful big toe. This condition is called “podagra”. This condition is prevalent in 3 out of every 4 gout patients.

 

What Are The Clinical Features?

Apart from the minor signs and symptoms, gout is associated with few major clinical conditions as well. These are-

  • Urate nephropathy: It is caused by the accumulation of urate crystals in the interstitial space of kidneys. It can lead to kidney stones and permanent renal failure.
  • Uric acid urolithiasis: It is characterized by bladder stones.

 

What Are The Different Types?

Depending on the severity of the disease, gout can be classified into two types-

  • Acute type: It normally affects the big toe, but can involve few other joints as well. It causes reddened, swollen and painful joints with peeled off the skin at the affected regions (erythema conditions). It usually occurs in the midtarsal, ankle or knee joints. The pain usually begins at night and can stay for 3 to 10 days. Swelling of soft tissues occur causing additional protrusions (tophi). Recurrent attacks might occur. In critical stages, acute gout can cause high fever and leukocytosis.
  • Chronic type: It results from undiagnosed cases of acute gout. It is characterized by severe inflammation and permanent damage (due to erosion and destruction) of the joint and associated soft tissues. With age, tophi become more prominent in the helix of the ear, interphalangeal joints. It usually lasts for a lifetime.

 

Which groups are vulnerable?

Research findings by World Health Organization (WHO) suggest that gout is 9 times more common in men than women. Males can develop tendencies of gout from the onset of puberty and suffer from chronic gout after 75. But women usually develop gout after menopause (due to a decrease in estrogen level). A person having a family history of gout has a 20% risk of having gout in future.

 

Diagnosis, treatment, and prevention

Gout in fingersDiagnosis of gout is done by physically observing the presence of swollen joints, usually the first metatarsophalangeal joints. There is swelling and redness along the joints. The doctor may also draw fluid from the swollen joint regions and test the fluid for the presence of uric acid. Several blood tests that indicate uric acid and creatinine level may also be used. Xray and MRI scans will be done in order to rule out other causes of joint inflammation.

There is no immediate and absolute cure for this condition. Treatment involves effective reduction of a uric acid level and reducing joint inflammations. The traditionally prescribed medicines are NSAID and Corticosteroids. But these have detrimental effects on patients having cardiovascular disorders, kidney diseases, and peptic ulcers.

The best preventive method recommended by doctors worldwide is to develop a healthy dietary habit and checking obesity tendencies through regular exercise. This, in the long run, will automatically increase work-level productivity and improve socio-economic standards of a nation.

 

 

Dos and Don'ts

Dos
  • A diet high in fructose is linked closely with the onset of gout. Remove high sugar products from meals and also decrease alcohol consumption.
  • Exercise regularly (minimum 15 minutes of exercise per week) and keep your blood pressure levels in check.
  • Sometimes, uric-acid lowering medications can lead to initial periods of flares but don’t discontinue your medications.
Don'ts
  • Let high uric acid levels accumulate in your body. Drink plenty of liquids and take uric-acid lowering medication to prevent this.
  • Consume food items which are rich in purines such as seafood and red meat.
  • Take aspirin tablets without consulting your doctor first since aspirin increases uric acid levels.

 

 

 

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Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Shilajit: A miracle Himalayan herb for an active and happy life The Himalayas contain more wonders than you thought. Shilajit is a miracle herb that is widely used in…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
anti ds dna test
Anti Ds-DNA antibody Test The  Anti Ds-DNA antibody test is used to diagnose the disease called lupus or more aptly the SLE(Systematic…
Ca 19.9 test
CA19.9 Test CA 19.9 is a cancer antigen that exists on the surface of cancer-causing cells. The levels of CA…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
CLA: A breakthrough weight loss supplement with minimal side effects Tried every weight loss supplement in the market with no substantial gain? Why not try CLA supplements, derived…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
What is Qigong and how can it help you channelize you inner “Qi”? Qigong is an integrated way of performing a traditional exercise regimen that can help in promoting health, mental…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
vital organ diseases
Common diseases that could cripple your vital organs Brain, heart, kidney, lungs, and liver - these vital organs are indeed vital for your survival. However, these…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Bronchoscopy procedure
Bronchoscopy Bronchoscopy is a procedure where in a scope is inserted into the lung pathway to observe any growth…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Hibiscus: Nourish your beauty and health with these vibrant blooms Hibiscus is a trumpet shaped flower found abundantly in tropical countries. It has been historically used for its…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Trisodium Phosphate: How a paint thinner made its way into your breakfast Ever thought how toxic chemicals find their way into our foods? How can they harm our body? And…
folate test
Folate test The Folate test measures and monitors the levels of folic acid in the blood. This test is also…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Alp enzyme-test
ALP test – Alkaline Phosphate ALP or alkaline phosphate is an enzyme mainly produced by the liver and gallbladder. ALP test measures the…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
edamame
Edamame: How healthy are these green baby beans? Edamame or "immature" soybeans are soft and easily digestable forms of soybeans that are great as an eveyday…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…

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