Gout or Gouty Arthritis
What is gout? All the information regarding the causes, symptoms, and treatments of this disease.
Symptoms and Causes
Gout is a disease that causes inflammation and pain in the joints (usually in the first metatarsophalangeal joint of the foot, which is the big toe) due to the accumulation of small uric acid crystals. When the deposits are large enough to form nodules that can be felt through the skin, they are called gouty tophi.
It typically manifests as attacks that cause sudden severe pain, almost always in the form of acute arthritis in a single joint (i.e., monoarthritis). Despite its intensity, gout usually responds well to both treatments and dietary changes, resolving without causing complications.
Symptoms
The usual symptoms of gout attacks are:
- Intense pain in the affected joint that worsens at night.
- Inflammation.
- Redness.
- Limited movement.
- When the disease progresses, tophi.
Causes
The cause of gout is hyperuricemia, that is, an increase in the concentration of uric acid in the blood.
Risk Factors
The risk of developing gout increases significantly in the following cases:
- Male gender.
- Between 30 and 50 years old.
- Women in menopause.
- Diets that raise uric acid levels: shellfish, red meat, fructose, or alcohol.
- Overweight.
- Diabetes.
- Hypertension.
- Some diuretics or medications for hypertension.
Complications
Gout can generate uric acid crystals that can move to the kidneys and cause renal colic.
Prevention
Some tips to prevent gout attacks include:
- Maintain a healthy weight.
- Avoid sweetened beverages, juices with fructose, and alcohol.
- Stay properly hydrated.
- Reduce red meat consumption.
- Include fish, vegetables, dairy, and fiber-rich foods in your diet.
Which doctor treats gout?
Rheumatologists are the specialists who diagnose and treat gout.
Diagnosis
The symptoms and lifestyle of the patient are one of the main indicators for diagnosing gout. To confirm the suspicion, the specialist conducts other tests:
- Physical examination and observation of the affected joint.
- Blood test to determine if there is hyperuricemia (more than 7 ml/dl).
- Synovial fluid analysis to detect uric acid crystals.
- Imaging tests (X-ray, ultrasound, or CT scan) to rule out other conditions and detect gouty tophi.
Treatment
The treatment for gout should be approached as two independent issues:
- Treatment of the acute gout attack
- Treatment of the elevated uric acid in the blood (hyperuricemia).
Initially, the affected joint should be de-inflamed, traditionally with oral colchicine. In the second phase, colchicine is combined with a urate-lowering treatment (allopurinol or febuxostat), and in the third phase, the urate-lowering treatment is maintained alone.
Once the symptoms resolve, it is recommended to make lifestyle changes that include physical exercise, maintaining a healthy weight, and introducing healthy foods into the diet.
