One of the waste products of the human body is uric acid. It normally exits the body through the kidneys. If its amount increases for certain reasons, and the kidneys cannot eliminate it, it accumulates in the body by forming crystals.
If uric acid crystals are contracted in the joints, tissue around the affected joint is inflamed, and inflammation irritates nerve endings in the joint and causes very severe pain; this process is called gout. Sometimes, the crystals are deposited in the kidneys themselves, causing renal insufficiency.
Since all people produce as much uric acid as it can be eliminated by the kidneys, everyone is, to some extent, prone to gout. In some people, the disease develops without a clear cause – except for innate predispositions. However, in many patients, gout is the result of some environmental factors that disturb the balance of uric acid. In such factors we could count lead poisoning, which is harmful to kidney function, and diseases such as psoriasis or leukemia.
The main symptoms are severe pain, sometimes in the elbow or knee, but more often in the hand or foot (often at the base of the knee). Pain usually occurs suddenly (though “experienced” patients may ”predict” the onset of the pain). After a few hours, the joint becomes so sensitive that the patient does not even bear the weight of the bedding. The elevated temperature (up to 38.5 ° C) often occurs. The inflamed skin on the joint is probably red, shiny and dry.
The first seizure affects only one joint and lasts only a few days. In some cases there are no more seizures, but usually the seizure is repeated – although it may take months or years – for the second and third and the fourth time, etc. The attacks occur at shorter intervals, last longer and affect more joints . If the disease is not treated, inflammation of the soft tissues around the joint and irritation of the bones can cause deformation of the bone, the skin of the joints can degenerate, and symptoms of kidney damage (such as kidney stones) are also possible.
Gout is one of the most common diseases of the joints. This disease usually affects men, and usually after puberty, while women are mostly affected after menopause. Some races seem to be more prone to gout, indicating possible genetic predisposition. Thus, for example, the disease is common in Polynesian, but relatively rare in Scots.
Of all the metabolic disorders, gout is probably the easiest to treat. However, if the disease is not treated, high blood pressure or kidney disease can develop.
What to do?
Although the first attack may weaken after a few days, and you will be left “in peace” for a longer period of time, contact your doctor. Do not use aspirin to treat the pain as it may slow down the secretion of uric acid; your doctor will prescribe you a suitable pain killer. Since, in some cases, the disease never occurs after this single seizure, no other therapy is usually advised at that stage. However, the doctor must know about any possible further seizures so that after a certain period of time you will be treated specifically.
After the first seizure, your doctor may advise you to change the eating and drinking habits. This particularly applies to fatty and spicy dishes, as well as alcohol, which should be reduced.
Self-help: you will alleviate the pain by putting hot or cold compress on the joint. You can avoid the pressure of the bedding with a protective frame (cage). Take only the pain medications recommended by your doctor.
Professional help: there are three “defense lines” (and if you are lucky, you will only need the first two). The first is pain relief with analgesic (but not aspirin), which will be prescribed by your doctor. The second line of defense is the suppression of inflammation. For this, doctors generally prescribe medicines taken on the mouth, placed in a anus (suppositories), or received by injection. Since gout symptoms may disappear after the first seizure, and the disease may ”lay low” for months or years, the doctor will not take other measures at first. However, if the symptoms reappear, the treatment must focus on the underlying cause (or causes), which requires a third defense line. Unfortunately, medicines used in this phase of treatment should be taken for a lifetime.
“Third line defense” drugs work in two ways. They primarily enhance the secretion of uric acid through the kidneys; your doctor will probably advise you to support this process by increasing the amount of non-alcoholic liquids, and perhaps the regular doses of bicarbonate sodium that neutralizes uric acid. The choice of drug depends on a number of factors, including the chemical balance of the body. If you take the medication exactly according to your doctor’s instructions, you can hope for a normal life.