Gouty Arthritis

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Gout, also known as metabolic arthritis or urarthritis, is a condition wherein the body loses its ability to handle uric acid. It occurs because either the body produces excessive amounts of uric acid or, as is more common, they lose the ability to eliminate it, which results in it building up in the body. Uric acid is the by-product of the metabolism of purine rich foods, particularly proteins. When uric acid builds up in the body it results in chronic and acute gouty arthritis, uric acid deposits in various joints and subcutaneous tissues, known as tophi, and kidney stones.

Gouty arthritis is diagnosed when a joint, usually the big toe, suddenly becomes swollen, painful, red and hot. The diagnosis is confirmed by finding monosodium urate, or uric acid crystals in the affected joint. These crystals keep accumulating in the joint for years and are responsible for triggering off the characteristic inflammatory and painful bouts of gouty arthritis.

Whom does Gouty Arthritis Affect?

Men are far more susceptible to gouty arthritis than women. The few numbers of women who do have gouty arthritis display symptoms only after menopause, hence, it thought that there is a hormonal factor involved in the condition. Gouty arthritis appears to be an inherited disease, however, it hardly ever manifests itself at birth, and neither does it occur for several years after that, instead, it usually occurs much later in life. Children almost never get gouty arthritis, with it usually occurring between the ages of 40-60.

Gouty arthritis is categorized into two types: 1) Primary, and 2) Secondary.

Primary Gouty Arthritis basically refers to the disorder occurring due to genetic reasons. While Secondary Gouty Arthritis occurs due to some other disease or because of a consequence of taking certain drugs.

While a condition known as hyperuricemia, wherein there is a high level of uric acid in the blood, may be indicative of higher chances of gouty arthritis occurring, however, it is not yet clear what the relationship is between gouty arthritis and hyperuricemia. For instance, many patients may have hyperuricemia and yet not get gouty arthritis, while some patients who experience several bouts of gouty arthritis have low or normal levels of uric acid.

What are the Symptoms of Gouty Arthritis

The most common area gouty arthritis occurs in is the base of the big toe, but it can affect other joints too such as the fingers, wrists, elbows, knees, and ankles. An acute attack of gouty arthritis is characterized by symptoms like sudden occurrence of pain in the joint along with the affected area becoming reddish, swollen, warm, and tender to the touch. In fact, the tenderness can be so acute that even the touch of a bed sheet touching the area can be intolerable. Along with the gout attack, fever, chills, an increase in the heart rate, and a general feeling of malaise may also develop. These attacks of gouty arthritis generally get resolved within a few hours or sometimes days, without or with medication. Rarely, an attack of gouty arthritis may last for a few weeks. Most people affected by gout usually experience attacks of gouty arthritis repeatedly over a number of years.

How can Gouty Arthritis Attacks be Prevented?

Making modifications to the diet is one of the best ways to prevent the recurrence of gouty arthritis. High purine foods can increase the levels of uric acid, so should be avoided, such as organ meats, which include sweetbreads, brains, kidneys, and liver; meats like lamb, pork, beef, and bacon; game meats; also large amounts of any other types of meat; seafood such as scallops, mackerel, herring, sardines, and anchovies; legumes, like dried peas and dried beans.

Alcohol inhibits the kidneys from releasing uric acid into urine, resulting in a build up of uric acid in the body. Beer seems to be the worst amongst alcoholic beverages, since it is high in purines.

There are higher chances of getting gouty arthritis attacks with being overweight. Hence, incorporating a weight reduction diet could help you to shed weight. However, care must be taken not to go on a low-calorie crash diet, because this increases the production of uric acid in the body, thus triggering off an attack of gouty arthritis.

Certain drugs that are prescribed for other conditions may affect the kidneys’ ability to eliminate uric acid, such as diuretics and nicotinic acid. It has also been found that the regular intake of low-dose aspirin increases the levels of uric acid. Since this is usually prescribed as a preventive against heart attack or stroke, you may have to continue using it.

If a drug has been prescribed for your gout, which lowers the levels of uric acid, such as allopurinol or probenecid, you need to continue taking it. But if you haven’t been taking any of these drugs before an attack, then once you do get a gouty arthritis attack, it is advisable not to take the medications, because it has been found that they can actually exacerbate the condition