An excess of uric acid in the body can accumulate in different parts of the body such as joints, kidneys or soft tissues, producing gout. Discover its phases, and drugs, habits and diet to control its symptoms.
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We could differentiate three Phases in the onset of Gout
The first, completely asymptomatic, would correspond to the increase of uric acid in blood.
This is followed by the formation of crystals in the joints, which will give rise to the most characteristic symptom of gout, known as acute gout attack. As the name suggests, this attack tends to occur suddenly, affecting one or more joints. The patient suffers very intense pain, which usually begins at night and subsides within days or weeks. Externally, the skin appears hot and reddened and is extremely sensitive to touch (rubbing the sheet or any other physical contact may be uncomfortable). As a secondary symptom, fever may occasionally appear.
The third phase would be the chronification of the disease, called gouty arthritis. This occurs when there is a repetition of attacks, which can happen long after the first attack. The recurrence of gout symptoms is usually more prolonged in time, and usually affects a greater number of joints than the acute attack. Once the attack is over, the symptoms disappear completely, at least at the beginning of the disease, because as the disease becomes chronic and the attacks begin to recur, the time between one episode and the next decreases and discomfort remains in the affected area.
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What is the Cause?
Gout is caused by excessive accumulation of uric acid in the body. Uric acid arises from the breakdown of substances called purines. Purines are found in all tissues of the body. They are also found in many foods such as liver, beans and anchovies.
Normally, uric acid dissolves in the blood, passes through the kidneys, and leaves the body in the urine.
Uric acid can build up in the blood when:
- the body increases the amount of uric acid it produces
- the kidneys do not eliminate enough uric acid
- you eat a lot of foods rich in purines.
You are more likely to suffer from gout if you:
- you have family members with the disease
- you are a man
- are overweight
- drink too much alcohol
- eat too many foods high in purines
- have a defective enzyme that makes it difficult for your body to break down purines
- are exposed to lead in the environment
- have had an organ transplant
- take medications such as diuretics, aspirin, cyclosporine, or levodopa
- take the vitamin niacin.
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Recurrent Gout Symptoms and Complications
The fact that a person has suffered a gout attack does not mean that he or she will necessarily suffer more. It is true that there is a fairly high rate of recurrences; approximately 50% of people who have suffered a first reaction will suffer others in the future. The consequences of chronic gouty arthritis can be: deformation of the joints, loss of joint mobility and almost continuous pain.
In cases where gout has lasted for many years, the appearance of tophi is common; these are lumps that form around the joint as a result of the progressive accumulation of crystals on top of each other. These formations are painless, but they may ulcerate or fistulate (form a fistula) and leak a whitish substance (urate crystals). Tophi are usually located in elbows, hand joints, Achilles tendon and the pinna.
In addition to the typical clinical picture, there are numerous complications associated with gout. It is very common for gouty patients to present signs of renal dysfunction, kidney vascular disturbances and renal colic, the latter due to the elimination of uric acid crystals in the form of stones. Also closely related to this type of arthritis are cardiovascular disorders and hypertension.
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How can it be prevented?
The disease itself cannot be prevented, but you can avoid things that trigger symptoms. Achieve control of comorbidities, lifestyle modifications such as limiting alcohol consumption and consuming a low purine diet and using medications to control hyperuricemia.
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