Warning Signs of Gout You Might Have Missed

Gout is a form of arthritis that affects about 1.6% of Filipinos according to the Philippine Rheumatology Association. When gout attacks, it causes sudden pain and swelling in the joints. But does it develop out of the blue? Or were there warning signs of gout you might have missed?

How gout develops

Gout is a type of inflammatory arthritis that affects one or more joints. It is an extremely painful condition caused by excessive uric acid in the body (hyperuricemia) that collects in and around the joints. Build-up is caused by either excessive production of uric acid, or your body excretes too little. Uric acid crystals are sharp and have needle-like shapes, thus causing significant pain in the affected area.

These episodes or flares of gout attack can last for days or weeks, and can be followed by a long period of remission, from weeks to even years. Once you develop gout, flare ups can happen at any time without warning. Gout is not curable, but fortunately it can be managed to reduce the likelihood of flare ups from occurring.  

A flare is characterized by the following:

• Severe pain. This can occur in one or more joints including your shoulders, elbows, fingers, toes, ankles, and knees.
• Swelling. The affected areas will appear inflamed and reddish. The site is tender and hot to the touch.
• Limited mobility. The pain becomes too severe that you will not be able to move affected joints as your normally would.

What you need to watch out for

While gout attacks are sudden, there are risk factors you can watch out for that may increase your chances of developing this condition, such as:

• Weight and Diet
  • Obesity
  • High-purine diet: intake of too much red meat, sardines, tuna, organ meat, and certain vegetables like cauliflower, green beans, and peas
  • High-fructose diet: processed fruit juice, soda, honey/syrups, processed salad dressings and more
  • Excessive drinking of alcohol, especially beer

• Medical Conditions and Family History
  • If you have certain conditions such as:
    • Hypertension
    • Diabetes
    • Kidney disease
    • Congestive heart failure
  • If you have family history of gout
• Medications
  • If you are taking certain medications: low-dose aspirin or antihypertensives such as thiazide diuretics, angiotensin converting enzymes (ACE) inhibitors, or beta blockers
• Age and Sex
  • Males are at higher risk for gout. The condition affects mostly men usually 30s and above, but older women may be affected too. Post-menopausal women tend to reach the same level of uric acid as men.
• Recent Surgery or Trauma

What to do when gout attacks

If a gout flare catches you off-guard, there are several things you can do:

• Address the pain. Do not attempt to stand up or stretch your joint. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce the pain, but there are also other treatments such as corticosteroids and a drug called colchicine. The more complex your case becomes, the more likely a combination of treatments may be prescribed.
• Prevention is key. Assess your lifestyle and health habits. Make adjustments as needed, like losing weight, limiting your intake of high-purine food, drinking less alcohol, etc.
• Consult your doctor. It may be your first gout flare or already a recurrence. Either way, it is best to consult your physician on how to manage this condition in the long term. Depending on your case, you may be prescribed treatment like allopurinol to lower your uric acid levels in the body.

It is important to involve a medical doctor to prevent further complications from developing. If gout becomes chronic, it can lead to the development of deformity in the joints, kidney stones, and in extreme cases, kidney failure.

Gout is a painful condition that has been around for a long time. Fortunately, modern medicine makes this condition treatable. It is important to remember that while men and older women are at higher risk for gout, anyone can still be affected by this condition as it is largely influenced by a person’s lifestyle and health status. Choose to take the healthy route to avoid this condition from developing as much as possible.

General disclaimer

Your doctor will always be in the best position to give the appropriate medical advice for your condition. For suspected undesirable drug reaction, seek medical attention immediately and report to the FDA at www.fda.gov.ph and UNILAB, Inc. at 8-UNILAB-1 or productsafety@unilab.com.ph. Always buy your medicine from your trusted drugstores and retailers.

Sources:

• PRA Launches Its Gout Awareness Campaign/
• Filipino Gout: A Review
• Gout: An old disease in new perspective – A review
• Gout - NHS Inform