What are Gout Symptoms and Signs?
Gout attacks strike without warning, although most of the flares occur at night. During a gout flare, the affected joint becomes swollen, reddish and hot. There is also the palpable tenderness of the joints affected by gout.
Gout has always been associated with the severe pain in the affected toe. While the chronic disease predominantly involves the big toe, it can actually affect other parts of the body. A recent study measured the incidence of gout in various parts of the body and came out with the following results:
- Big toe – 76 percent
- Foot or ankle – 50 percent
- Knee – 32 percent
- Finger – 25 percent
- Elbow – 10 percent
- Wrist – 10 percent
Gout is a chronic medical condition and may have long term effect on individuals who have it. Among the concerns involve the effects in between gout flares. Tophi, which are the naturally occurring crystals derived from uric acids, accumulate in the synovial fluid of the joints not only of the feet and hands but of the Achilles tendon and elbow as well.
Other long term effects of gout include damage to the affected joints, chronic pain and progressive degradation of mobility of the affected tendons and joints. It is a progressive and chronic disease and it gradually worsens over time.
Stages of GoutStage 1: Asymptomatic with elevated levels of uric acid – This gout stage is generally characterized by high levels of uric acid in the bloodstream. At this stage, the patient has not experienced any gout attack yet and because of this condition, the patient doesn’t have gout in the strictest sense of the word. Medical professionals usually refer to this medical condition as “asymptomatic hyperuricemia.” Not all people with elevated levels of uric acid will develop gout.
In the same manner, those who develop the chronic disease do not necessarily have high levels of uric acid in their bloodstream. In fact, there are documented cases of individuals who have had consistently high uric acid levels for 20 years before developing the disease and experiencing their first gout flare. As a general rule, if you have high uric levels, it is necessary that you consult with your doctor in order to assess your predisposition to the disease.
Stage 2: Gout flares – Conditions characterized by gout attacks are referred to by medical professionals as “acute gout.” It is medical condition that is predominated by the formation and accumulation of uric acid crystals and inflammatory state. The inflammation is the precursor to the severe pain and swelling of the affected joints. Gout attacks have had a fair share of metaphors, and these include terms like walking on hot coals, jackhammer and blowtorch. Once you experience gout attack, chances are it will become a recurring medical condition requiring lifelong treatment.
Nearly 80 percent of men and women with gout will experience their second gout attack within the next 6 months from the onset of the initial flare. Subsequent flares become more widespread and affect more than one joint at any given time. The initial gout attacks are less severe and as the disease worsens, the flares become more intense and pronounced. The flares will also last longer and patients will require longer recovery period as the gout progresses.
Stage 3: Between Gout Flares – This is the penultimate phase involving the gaps between the gout flares which is also a critical aspect in the management and treatment of gout. Medical professionals refer to this stage as “intercritical gout.” Patients with gout must take note of the fact that the condition still persist, albeit asymptomatic, even when there are no painful gout flares.
Results of various researches indicate the uric crystals are still present in the affected joints as long as a person has elevated levels of uric acid. This means that damage to the joints persists even during the gaps or lull periods between gout attacks.
Stage 4: Chronic Form of Gout – This is the final phase of this chronic disease. It is referred to by medical professionals as the “chronic tophaceous gout.” Stage 4 is the most debilitating phase of gout. As the medical condition worsens and become widespread, the gap or lull periods between flares become less pronounced until such condition completely disappears. The patient will experience uninterrupted or persistent inflammation of the joints. This final stage of the disease is characterized by chronic pain, tissue damage and severe degradation and deformities to the affected joints.
Is Gout Hereditary?
Is there a clear or substantive link between gout and genetic makeup of an individual? Can we consider gout a hereditary medical disorder? Family history is always recognized by medical professionals as one of the risk factors of gout. However, its relevance or actual impact is not exactly known. Various scientific studies provide a high variance in the familial incidences and the figures range from a low 11 percent to as high as 80 percent. In most cases, several genes were observed to have varying degrees of control or effect on the levels of uric acid in the bloodstream. Thus, the gout incidence remains highly variable when family history is considered.
Several studies define the extent of the role of genetics in the development of gout. Since most medical experts agree that at least 25 percent of those who are suffering from gout have a family history of the disease, then it is likely that lifestyle and diet are not the only risk factors that we need to take into account.
This means that it may be relevant that you look into your family history and find out if there is indeed an existing pattern in the incidence of gout. This will help you prepare and prevent the medical condition that may be passed down to you. A growing number of medical experts believe that our genes play a significant role in gout incidence since there are people who develop the disease for no apparent reason. There are cases of gout development in people who were found to have enzymes and chromosomes that manifest major issues or abnormalities, and such conditions may persist from one generation to the next.
These hereditary issues associated to gout development have direct impact on the manner by which the foods we consume are metabolized by the body. Specifically, there are certain enzymes that are responsible for the conversion of food molecules from one form to another, such as sugar molecules being converted into fat molecules. The substance is passed down to an enzyme pathway, where each of the involved enzymes performs a specific function. How these enzymes are made is largely defined by the genes, and about one in every 100 individuals, will manifest varying defects or issues on how these genes function. These abnormalities lead to dysfunctions or disruptions in the conversion of food molecules.
As far as gout is concerned, its incidence can be linked to an inborn anomaly which is associated to the nucleic acid metabolism that is characterized by the overproduction of uric acid or inability by the kidneys in eliminating the uric acid. The exact reason or cause of the metabolic anomaly is not clear. This dysfunctional state may not be immediately apparent and can only be “triggered” by some external variables such as exposure to extreme cold, excessive intake of proteins, alcohol consumption, trauma and infection. This dysfunctional metabolic process that is linked to gout problems may also play a major role in the development of other medical conditions like kidney disease, obesity, anemia and diabetes.Gene Variant SLC2A9 and Gout
A team of medical scientists from Western General Hospital at Edinburgh as well as those from other research centers in Croatia, Germany and the UK have announced a major breakthrough in their effort to clearly define the link between genetics and gout development.
Gout incidence has long been associated to lifestyle and diet of an individual. It is a well known fact that this painful chronic disease is caused by overconsumption of refined sugar, protein and alcohol. However, there remain a significant number of individuals who don’t develop the disease despite having lifestyle and diet that predispose them to gout.
A scientific study involving genes of over 12,000 individuals has drawn new insights that defined how an individual may become susceptible to this medical condition. According to the medical scientists who were involved in the scientific study, gout incidence can be explained by the gene variant SLC2A9. This is the gene that is primarily responsible for the transport of fructose.
Results of the study have shown that this gene variant also plays an important role in the transport of uric acids in the bloodstream. They have found out that up to 5 percent of the variance in the uric acid levels in the blood can be attributed to the presence of this gene variant. Specifically, the gene variant turned out to be the common variable in a significant number of the individuals involved in the study that have low levels of uric acid. Medical experts believe that these gene variant has some degree of control in the ability of the kidneys to break down and filter uric acid from our bloodstream.
While there are a growing number of evidences that would link genetics and gout incidence and consider lifestyle and diet changes, proper medical management and prevention of the disease should always begin with the appreciation of various treatment modes for gout.
Relation between Gout and Alcohol Consumption
It is an established fact that alcohol consumption is directly related to elevated levels of uric acid in the bloodstream. However, the role of alcohol in actually increasing the chances of developing gout has not been established, until recently.
Several scientific studies have established the direct link between alcohol consumption and the incidence of gout. While those who consume more beer than liquor tends to become more prone to the chronic disease. Recent scientific studies have shown that there appears to be a strong correlation between alcohol intake and the ability of the body in getting rid of uric acid.
The major findings of a scientific study that was published in the medical journal The Lancet involving some 47,000 males with no gout history established a clear correlation between alcohol consumption and the incidence of gout. Results indicate that nearly 2 percent of the respondents experienced gout flares. Those who consumed most alcohol on a daily basis demonstrated twice the risk of gout as those men who did not consume alcohol at all.
Habitual beer drinkers in particular increased their risk of getting the disease by 50 percent while those men who were into hard liquor increased their risk of developing the disease by 15 percent. On the other hand, those men who drank wine did not appear to increase their chances of getting the chronic disease.Beer and Gout Incidence
The study has provided conclusive results indicating that the consumption of beer trigger gout attacks primarily due to its high content of purine. This clearly shows that gout sufferers need to cut down on their consumption of beer, although wine may be allowed as long as it is taken in moderation.
The negligible effect of wine consumption on gout sufferers doesn’t necessarily mean that there is no correlation between the two. Medical experts recognize the need for further study on the components of wine which may have protective characteristic that are beneficial to gout sufferers.
While several scientific studies have clearly shown the substantial benefit of reducing alcohol consumption, gout sufferers need to consider best treatments for gout to alleviate the symptoms associated with the condition. At best, reduction in alcohol consumption can complement the effective gout remedies and minimize the recurrence of gout flares.
A Cure For Gout?
Currently, no one has found a permanent cure for gout. In fact, those who treat gout do so with a goal to manage the pain and swelling that are associated with it. In this article we will discuss a cure for gout as it relates to managing the pain and helping you live a normal and active lifestyle.
Gout occurs because there’s too much uric acid in the body. When there’s too much uric acid it will deposit itself into muscle joints. After it is deposited into the joints, it will begin to crystallize. As crystals form it will cause swelling and pain when the joints rub against the crystals.
Uric acid is naturally removed from your body through the kidneys during urination. If a body is producing too much uric acid the kidneys will not be able to eliminate enough of it to stop it from depositing itself into your joints.
What causes an excess in uric acid? Two things, a diet that is high in purine and a body which does not properly filter out the uric acid. Either of these things, or a combination of both of them, will heighten your risk for gout. It is also a form of arthritis.
The cure for gout is to make sure your body is properly getting rid of uric acid and not putting too much purine into your body to cause the uric acid to become excessive.
This means you want to avoid foods and beverages that are high in purine. The two biggest culprits are red meats and alcohol. Often, attacks will occur shortly after red meats or alcohol is consumed.
Other foods to avoid that are high in purine include seafoods, sweetbreads, anchovies, sardines, gravy and asparagus.
When someone suffers from gout attacks, the main cure for gout attacks that is prescribed by doctors deals with medication. They will generally give you anti-inflammatory drugs that offer both pain relief and reduction of swelling.
However, the best cure for gout is simple. It means living a healthy lifestyle with the proper exercise and diet. It means staying hydrated and avoiding foods and beverages that cause dehydration. By reducing your meat consumption and replacing it with raw fruit and vegetables you greatly reduce risk of suffering from gout.
Treatment for Gout
It is important that you talk to your doctor if you are suffering from gout attacks so that appropriate medical interventions can be undertaken. Your doctor may prescribe specific treatments for gout or recommend natural gout medications. However, you have to remember that the treatment modes for the pain and inflammation don’t address the main cause of gout, which is the elevated level of uric acid. Effective medical management of the chronic disease may involve natural gout medications that can help you maintain the level of uric acid below 6 milligrams per dL of blood.