What is it?
Gout is a type of arthritis that occurs when extra uric acid in the body forms crystals in the joints. The crystals cause pain and swelling.
Throughout history, gout has been referred to as the ” disease of the kings ” , and has been clearly associated with the lifestyle of the aristocratic social classes.
Poor peole could not afford meat, and their diet was based on legumes, vegetables and potatoes.
For this reason, nobles suffered from gout, while this was completely absent in lower classes.
Aetiopathogenesis
A gout condition can be characterized by:
- High levels of uric acid in the blood.
- Muscle and joint pains.
- Kidney fatigue.
- Motor-coordination difficulties.
- Primary gout is not associated with an identifiable cause, other than perhaps a family history.
- Secondary gout refers to the presence of a recognized cause or precipitating factor, such as lymphoma (especially following chemotherapy), the excessive use of alcohol, or the use of diuretics.
Ina any case, gout is a curable disease, if a healthy diet and a correct lifestyle are followed.
Causes
Gout can be caused by different factors:
- Dietetics;
- Side effect from drugs;
- Reduced ability of the kidneys to dispose of uric acid.
The body produces uric acid during the breakdown of purines. These are chemical compounds found in high amounts in certain foods such as meat, poultry, and seafood.
Uric acid is dissolved in the blood and excreted from the body in urine via the kidneys. If a person produces too much uric acid or does not excrete enough, it can build up and form needle-like crystals. These trigger inflammation and pain in the joints and surrounding tissue.
The immune system recognizes these crystal deposits as antigens and starts attacking them creating the typical inflammation of gout.
Risk factors
Among the main risk factors are:
- Studies have suggested a link between chronic lead exposure and an increased risk of gout.
- Pathologies that alter the cellular turnover rate such as tumors, haemolytic anemia or psoriasis;
- High pressure;
- Hypothyroidism;
- Overweight;
- Familiarity;
- Gender, as the condition is more common in men than in women;
- Diuretic drugs, since these reduce the body’s ability to eliminate uric acid from the blood;
- Levodopa given to patients with Parkinson’s;
- Aspirin or cyclosporine.
Classification
There are different types of gout:
- Acute attack of gout occurs when urate crystals in a joint suddenly cause acute inflammation and intense pain;
- Asymptomatic gout occurs when there are elevated uric acid levels without any outward symptoms;
- Chronic tophaceous gout is the most debilitating type of gout and may result in permanent damage to the joints and the kidneys;
- Interval or intercritical gout characterised by periods in between attacks of acute gout.
Diagnosis
Gout can be detected with several tests:
- Uric acid blood test;
- Urinalysis;
- Orthopedic visit;
- Phlebologist visit;
- A synovial fluid analysis can consist of several tests which may be performed on the fluid extracted from the joint;
- Magnetic resonance imaging.
Symptoms
- Redness and pain in one or more joints;
- Increased sensitivity;
- Physical fatigue;
- The areas most affected are the feet, ankles, heels, knees, wrists, fingers and elbows.
Pharmacological therapy
Drugs more commonly prescribed for gout include:
- NSAIDs and anti-inflammatories;
- Colchicine increases uric acid excretion;
- Allopurinol inhibits the generation of uric acid.
Natural remedies
There are a number of herbs that increase uric acid excretion in the urine: white willow bark, ginger, birch, poplar, meadowsweet flowers, safflower essential oil of rosemary.
Diet
A healthy diet is essential for gout, since being overweight increases the risk of developing gout.
In general, the most important dietary tips are:
- Avoid red meat, cured meats, alcohol, crustaceans and molluscs, as they are high in purines;
- Increased water intake can help kidneys to eliminate uric acid;
- Steamed or baked foods are preferable in case of gout for their organoleptic properties;
- Season the foods with vinegar, lemon and spices;
- Avoid foods high in fructose and lactose as they are pro-inflammatory;
- Alternate cereals with gluten to low-gluten or whole-grain cereals on a weekly basis, as the latter have a less inflammatory action.