Gout – causes, symptoms & therapy

causes

Gout is one of the most common metabolic diseases caused by poor nutrition. The main problem is the excessive intake of purine-containing foods such as meat, offal and alcohol , because the uric acid is formed when purine is processed.But mistakes in diet , especially in combination with insufficient fluid intake, can also lead to gout, since the breakdown of the body’s own protein also releases purine.

In addition, there can be an increased production of uric acid due to heavy physical exertion, massive obesity, serious blood diseases and tumors.

Kidney diseases, heavy alcohol consumption and high blood pressure all contribute to reduced uric acid excretion.

Gout can occur in two forms: acute or chronic. Acute hyperuricemia also occurs spontaneously in healthy people due to the presence of uric acid crystals with an otherwise normal uric acid level. Chronic gout occurs when elevated uric acid levels are not permanently reduced.

When to the doctor?

A gout attack usually goes away on its own after a few days to a maximum of two weeks. If the symptoms are particularly intense or last longer than usual, a doctor should still be consulted. If acute gout is suspected , medical advice is always indicated. Especially when the individual joints are very painful and everyday movements are hardly possible. Additional signs of inflammation such as reddened, swollen or overheated joints indicate a severe course.

The following applies here: See a doctor immediately, before chronic gout develops. Otherwise, the practice should be visited if the typical accompanying symptoms such as fever, headache or tachycardia do not decrease after three to four days or even increase in intensity over time. At the latest when kidney stones, chronic pain or persistent joint stiffness are noticed, a doctor must be consulted. In the event of symptoms of acute organ failure, an ambulance must be called immediately. In severe cases, first-aid measures must be carried out at the same time.

symptoms and course

Typical symptoms of gout:

• body aches

• swelling

• joint inflammation

• skin redness

• hot skin

• Fever

• Vomit

In most cases, a gout attack does not announce itself. The base joints of toes or fingers are particularly often affected. But also the metatarsal and knee joints as well as the base of the thumb quickly show the first visual characteristics in the form of small, painful bulges. The affected areas are often very warm and tend to itch. In addition, patients complain of increased sensitivity to touch. Later, the reddened skin begins to peel. Particularly large accumulations of crystals, also known as gout tophi, are deposited in bursae, cartilage or the kidneys over the long term. The first seizure occurs primarily at night.

If left untreated, the symptoms can persist for up to two weeks. Sometimes side effects also occur. These include headaches, tachycardia , slight fever and also pronounced nausea with a sharp drop in willingness to perform. In the long term, the disease restricts the mobility of individual joints and thus the mobility of people.

course of the disease

Without medical attention, gout can become chronic. Kidney stones and permanently destroyed joints as well as restricted kidney function then represent an uninterrupted burden for the patient. To prevent this from happening, timely treatment is urgently recommended. This efficiently alleviates the symptoms and sequelae and largely enables a normal life. Overall, the disease is divided into four stages:

• Hyperuricemia marks the beginning and is characterized by elevated uric acid levels without symptoms.

• In the second phase, an acute gout attack, patients first have to contend with painful swelling, typically in the toe or ankle. Depending on the intensity, a decrease in mobility can already occur in the affected areas.

• The third stage, the intercritical phase, on the other hand, is characterized by a longer period of freedom from symptoms between individual gout episodes.

• In the final, fourth stage, patients suffer from permanent changes in the skin and joints as well as chronic pain. Additional urine crystal deposits in the kidneys or ears also affect the quality of life of those affected. However, thanks to appropriate therapeutic approaches, such a severe course is rarely encountered anymore.

Diagnose

Gout is diagnosed through blood tests and imaging to show damage to affected joints. First, the blood test is carried out, here elevated uric acid levels indicate gout. However, it is possible that in the case of an acute gout attack the uric acid values ​​are only slightly increased or not at all, but the inflammatory values, especially the CRP, show a clear increase. In such a case, the removal of synovial fluid can continue: if uric acid crystals are found, these are a clear indication of gout.

To secure the diagnosis, the doctor treating you uses imaging methods such as X -rays , CT scans and MRTs to detect damage to the joints. In some cases, an ultrasound examination of the joints is also an option.

A careful anamnesis and knowledge of the medical history can usually make the diagnosis quickly. When gout is diagnosed, the kidneys are examined for their function – because the disease can be associated with kidney damage

complications

The later the disease is diagnosed and treated, the fewer the treatment options for existing damage to the bone and skeletal system. In an advanced stage, the joints become deformed and can no longer be corrected. The joints can no longer be moved as usual, so compensating movements are carried out. Permanent impairments occur, which lead to misalignments and one-sided loads. The healthy regions are subjected to a lot of stress, so that they can be injured and damaged. In addition, muscle and nerve fibers are exposed to an unusual strain and react with pain, hardening or inflammation.

The joints affected by the gout are red and warm. An increased body temperature can occur and symptoms such as nausea and dizzinesstrigger. Gout causes crystal deposits in the body that cannot be removed. Gout increases uric acid levels. This process promotes the formation of kidney stones and influences kidney activity. Inflammation of the kidney or urinary tract may develop. Pain occurs and renal colic threatens. The symptoms reduce fluid intake. This can lead to an undersupply of the organism and dehydration. The administration of medication can lead to an intolerance reaction. There is a risk of functional and organ disorders that further worsen the state of health.

treatment and therapy

Treating gout is a two-step process. First of all, especially in the acute form of hyperuricemia, the severe pain must be relieved with medication and the focus of inflammation treated.

For this purpose, the doctor can inject the patient with cortisone in combination with a local anesthetic in the focus of inflammation. But the entire range of anti-rheumatic drugs is also suitable for the treatment of gout.

Furthermore, it is essential to lower the uric acid level in the medium to long term and bring it back into the normal range. This can only be achieved through a controlled change in diet by reducing the amount of purine supplied – the breakdown of which produces uric acid.

↳ More information: Home remedies for gout

Specifically, this means reducing the consumption of alcoholic beverages, high-fat meat and sausage products, soup cubes, legumes and offal.

At the same time, make sure you drink enough fluids. If you are overweight , you should lose weight in moderation. All these measures contribute to the consistent change in diet and lifestyle.

prevention

How can gout be prevented? Regular health check-ups including the determination of the blood count provide information about the uric acid level, which is considered an indicator of a possible gout disease.The family history is also important in this context. Is there a family history of hyperuricemia? Then those affected should definitely start early with a conscious change in eating habits.

But other factors such as high blood pressure can subsequently be associated with gout. Therefore, it makes sense to check whether there is a family history of high blood pressure in order to lower it with medication if necessary. It is important to fight gout consistently.