Ouch! It's gout
Your big toe's red, it's exquisitely painful, and you can't even touch it. It's gout.
MY friend has a very painful big toe. He went to the doctor and was told he had gout. Apparently, his father had it too. What is gout?
Gout is a condition caused by too much uric acid in your body. This causes tiny crystals of urate to form and deposit in your tissues, thereby causing inflammation, especially your joints.
These uric acid crystals can also become kidney stones and adversely affect kidney function.
Gout has been known as the "king of diseases and the disease of kings". It is one of the oldest documented diseases, since the days of the ancient Greeks.
Gout is associated with being obese, rapidly gaining weight (especially when you were young), having high blood pressure, having high cholesterol, diabetes, and dehydration.
Gout is nine times more common in men than women. If women get it, it's usually after menopause.
What is uric acid? Why do we have it in our body?
Uric acid is actually the product of the breakdown or metabolism of purines, which are present in our cell DNA. As our body's cells die, the chromosomes break down and release purines, which are then converted to uric acid.
This uric acid is then excreted in the urine and gut. If our kidneys fail to get rid of the excess uric acid, or if we produce too much uric acid, then we can get hyperuricaemia (high uric acid levels in our blood). In fact, a disease impairing kidney function is the usual cause of high uric acid, as well as conditions that produce a lot of cell breakdown, such as leukaemia and other blood disorders.
About 10% of people who have high uric acid levels in their blood are natural overproducers of uric acid.
If you have hyperuricaemia, it is actually considered a precursor to getting gout, even if you have no symptoms right now.
Purines are also present in the food we eat, such as meats. Some drugs, like thiazides, cause hyperuricaemia too.
How will I know I have gout?
Arthritis is the most common way gout presents. And the joint that is most affected is the small joint at the base of your big toe.
A gouty attack is extremely painful. The pain comes on very rapidly, and is quickly followed by inflammation – manifested by warmth, swelling, tenderness, redness.
In fact, your toe can be so tender that you can't even put a sock over your foot. You may even have fever.
These gouty attacks can last from several hours to several days, or in the very worst cases, several weeks. Most people with gout will have repeat attacks.
Other than your big toe, other joints that can be affected are your ankles, knees (note that gout favours your lower limbs), wrists, fingers and elbows.
You may also have inflammation of your bursae, which are small fluid-filled sacs around your joints. This is called bursitis. Again, it is caused by uric acid crystal deposits.
Another type of skin manisfestation of gout is called tophi. Here, actual nodular masses of uric acid are deposited in the soft tissues of your body, most commonly around your fingers, elbow tips, ears, and big toe. Very rarely, they can be deposited in your vocal cords or even your spinal cord!
Tophi usually appear when there is an extremely high amount of uric acid in your body.
Gouty attacks are precipitated by fever, dehydration, injury to your joint, too much eating, too much alcohol consumption, and surgery.
Okay, let's talk about eating. Are there certain types of food I should avoid? I was told that if I eat a lot of meat, I can get gout. Is this true?
Purine heavy foods include animal organs (for food) such as liver, kidneys, brains. Shellfish like mussels, prawns, crabs are also very rich in purines. In beverages, alcohol, especially beer and hard liquor, and corn syrup-based soft drinks are the ones that are most associated with gout.
If you have gout, you should avoid these foods as they can precipitate and increase the frequency of your attacks.
It is not true that all protein-based foods cause an increased risk of gout. The rest of the protein based foods and vegetables are perfectly okay when it comes to gout.
If you are overweight, it would help greatly to decrease your weight.
Is there any treatment for gout?
Yes. For acute attacks of gout, there are medicines that reduce the inflammation and alleviate your pain. But it is more important to prevent such attacks from recurring by reducing your weight, avoiding foods and beverages that are known to precipitate the attacks and lowering the uric acid in your blood through medication.
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. Original article from The Star