What is Gout Disease? What Are Its Symptoms and Treatment Methods?

Historically known as the disease of kings, gout disease is characterized by an increase in uric acid circulating in the blood, leading to arthritis, or joint disease. The symptoms of gout develop based on the accumulation of uric acid crystals in the joints and the body’s reaction to them. Gout attacks typically occur at night without any prior warning. Many gout patients recover by paying attention to their diet and lifestyle, while some require medical treatment.

What is Gout Disease?

Gout disease is a common form of arthritis that can affect anyone. While it is classified among rheumatic diseases, it can also be described as a metabolic disease. This condition is characterized by sudden, severe swelling, redness, and tension in the joints, most commonly affecting the big toe joint. Attacks often present as a burning sensation in the big toe, which can wake individuals from sleep at night. The affected joint is hot, swollen, and so tense that it cannot tolerate even the weight of bed sheets. The symptoms of gout can sometimes disappear and reappear. Following recurrent gout attacks, permanent accumulation of uric acid crystals in the joint can lead to the formation of swellings known as "tophi," which deform the joint's shape.

What Causes Gout Disease?

Gout disease occurs due to the accumulation of uric acid crystals in the joints and the inflammation caused by the body’s reaction to these crystals. The accumulated uric acid crystals cause severe pain in the joints. When the amount of uric acid circulating in the blood increases, uric acid crystals form. Uric acid is a byproduct of the metabolism of purine-containing substances that naturally occur in the body. Purines are also found in high amounts in meat, meat products, and seafood. Additionally, it is known that alcoholic beverages, especially beer, and beverages sweetened with fructose increase uric acid levels in the body.

Normally, uric acid dissolves in the blood and is eliminated through urine by the kidneys. However, in some cases, either the body produces excessive amounts of uric acid, or the elimination of uric acid from the kidneys decreases. In this situation, the accumulated uric acid develops into sharp, needle-like crystals, which accumulate in the joints or surrounding tissues, causing pain, inflammation, and swelling.

What Are the Risk Factors for Gout Disease?

The risk of developing gout disease increases when uric acid levels in the body are high. Factors that increase uric acid levels can be listed as follows:

• Diet: A diet high in meat and meat products, as well as a habit of consuming sugary drinks sweetened with fructose, raises uric acid levels in the blood. Consumption of alcoholic beverages, especially beer, has also been reported to increase uric acid production.
• Obesity: In overweight individuals, both uric acid production is high, and the elimination of uric acid from the kidneys is decreased.
• Chronic diseases: Certain diseases increase the risk of gout. Chronic conditions such as uncontrolled high blood pressure, diabetes, metabolic syndrome, and heart and kidney diseases elevate the risk of gout.
• Medications: Thiazide diuretics used in hypertension treatment, low-dose aspirin, and immunosuppressive drugs used in organ transplant patients can lead to increased uric acid levels in the blood.
• Family history: Individuals with a family history of gout in first and second-degree relatives have a higher risk of developing gout compared to others.
• Age and Gender: Gout disease generally occurs more in men. Women have lower uric acid levels in the blood. However, after menopause, uric acid levels in women rise to those found in men. Additionally, gout often appears earlier in men (usually between the ages of 30-50), while in women, gout is observed after menopause.
• Recent trauma or surgery: People who have recently experienced trauma or surgery have an increased risk of experiencing a gout attack.

What Are the Symptoms of Gout Disease?

The symptoms of gout disease typically arise suddenly and at night.

Severe Joint Pain
Although gout disease usually affects the big toe joint, it can involve all other joints as well. Other commonly affected joints include the ankles, elbows, wrists, and fingers. The pain is usually most intense during the first 12 hours of an attack.

Persistent Joint Discomfort
After the initial severe pain attack, discomfort in the joints can last from a few days to several weeks. Recurrent attacks tend to last longer and affect more joints.

Inflammation and Redness
Due to inflammation in the affected joint, swelling, tightness, and intense redness can be observed.

Restricted Mobility
As gout disease progresses, the joint's range of motion decreases, and affected individuals may begin to have difficulty using their joints.

How to Follow a Gout Disease Diet?

The answer to how to cope with gout disease lies in a proper diet. It is possible to prevent the development of attacks through diet and to reduce the severity of an attack when it occurs. Important dietary considerations include:

• Consuming plenty of fluids, especially avoiding drinks sweetened with fructose, starting with water.
• Meeting protein needs through low-fat dairy products.
• Limiting the consumption of meat, fish, and poultry. Small amounts may be tolerated by gout patients. Additionally, determining which of these sources is more harmful to the individual is crucial for nutrition.
• Preventing weight gain and losing weight by consuming small portions. It is essential to avoid rapid and excessive weight loss, as this can suddenly raise uric acid levels.

Diagnosis and Treatment of Gout Disease

The diagnosis of gout disease is usually made based on the patient's medical history, dietary habits, medications used, and physical examination findings. Additionally, elevated levels of uric acid and inflammation markers in the blood can aid in diagnosis. In patients with advanced gout disease, uric acid levels in blood tests can rarely be found to be normal. It is also important to note that there may be patients with high uric acid levels in blood tests who do not develop gout disease. Radiological methods can also be used to show findings in the joint affected by gout disease. Although not frequently employed, a diagnosis can be made if necessary by an expert physician taking a sample of the fluid accumulated in the joint using a needle and observing uric acid crystals under a microscope. Uric acid crystals can also accumulate outside the joints, especially in the kidneys, leading to the formation of uric acid stones and potential deterioration of kidney function over time.

During acute, newly onset attacks, pain relievers, anti-inflammatory medications, and sometimes corticosteroid-containing treatments may be used. Additionally, after the acute period has passed, medications that reduce uric acid formation and increase uric acid excretion in urine are introduced to prevent new attacks.

More important than medications is the need for individuals to regulate their dietary habits, stay hydrated, lose excess weight, and avoid wearing tight shoes that squeeze the toes, in order to prevent the development of gout attacks and the increase of uric acid levels.

If you believe you have gout disease or are seeking treatment methods for your gout, do not hesitate to contact a specialist.