An introduction to gout
Gout generally comes in short attacks, coming on quickly over a few hours and lasting up to a week.
Gout affects joints, most commonly starting in the big toe. Between these attacks, the joints feel normal. The causes and symptoms of gout vary little from person to person.
What causes gout?
The primary factor causing gout is the amount of uric acid in the body. When levels in the bloodstream are too high, and the body cannot effectively excrete it, crystals may form around the joints.
It is these crystals which cause pain and inflammation during an attack of gout. In some cases, the reason for the increased level of uric acid is a bit of a mystery, in others, there are a number of contributory factors. These include:
- Sex and age
Often understanding what is causing your gout helps you to find an effective treatment. For example, some simple diet changes may considerably ease your symptoms.
What are the symptoms?
The symptoms are generally consistent from person to person, making it a fairly simple condition to diagnose. These come on relatively quickly, initially usually only affecting one joint, often the big toe. The most common symptoms include:
- Intense pain
- Changes to the surrounding skin, including redness, itchiness or flakiness
After a week or so, these symptoms usually subside and the joint feels completely normal. However, the chances that you will have another attack of gout are high, and often the longer you have had the condition, the more frequent the attacks become.
Your diet has a huge effect on this condition. Some foods are rich in a natural substance known as purines. These are broken down into uric acid by our bodies and it is uric acid which gives rise to gouty arthritis. For this reason, controlling the amount of purines you are consuming is the first step towards managing your problem.
Certain foods and drinks are high in purines so are best minimised, or even avoided, particularly during an attack of gout. Alcohol and red meats are the most common triggers for the condition.
On the other hand, some other foods are good for lowering uric acid levels. These include low fat cottage cheese or milk, and certain fruits such as pineapples and cherries. It is also important to keep hydrated by drinking plenty of water as this helps to flush out the uric acid from the body.
Are there herbs to help gout?
Aside from managing your condition through diet, there are certain herbs which may ease your symptoms. Herbal remedies can be split into two groups: those which ease the symptoms, and those which flush toxins out of the body.
There are herbal remedies which have been found to ease the swelling and pain of affected joints. Such herbs include Devil’s Claw which has a strong anti-inflammatory action, but does not result in the side-effects commonly associated with steroids.
Additionally, Arnica also has anti-inflammatory action, and as a result should help to ease pain. It can be applied externally to the affected joint.
Herbal remedies such as Golden Rod or Milk Thistle are remedies which are taken internally to support the function of the liver and kidneys, helping them to flush out toxins, such as uric acid, from the body.
What about conventional medicines?
Your doctor is likely to initially recommend an anti-inflammatory drug to resolve the symptoms. However, he may also suggest drugs to take on a long-term basis to reduce the frequency of gout attacks, by lowering the level of uric acid in the bloodstream. These drugs are allopurinol or febuxostat.
Complications of gout are not common and often not serious. However, they are a signal that your gout could be managed more effectively, and therefore it is worth examining your diet and treatment plan. The most common complications include:
- Tophi – these are small white bumps (of crystallised uric acid) around the affected joint or ears
- Joint damage – this is usually irreversible, and is caused by urate crystals damaging soft tissue, giving rise to rheumatic or arthritic type pains
- Kidney stones – high levels of uric acid may also cause kidney stones, which can be very painful, and may need to be surgically removed.
Often once an initial diagnosis of gout has been made, and an effective treatment plan drawn up, it is not necessary to go back to the doctor. However, if complications develop or you are worried about your condition, it is important to seek medical advice.