General Practice 2022

Gout: what é, causes, symptoms and treatment

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Gout: what é, causes, symptoms and treatment
Gout: what é, causes, symptoms and treatment

Gout or gouty arthritis is an inflammatory disease caused by excess uric acid in the blood (where the urate concentration exceeds 6.8 mg/dL), which ends up affecting the joints. However, not all people who have an increased rate of high uric acid will develop gout, as the condition is dependent on other factors.

Symptoms include swelling, redness and pain when moving a joint, the most commonly affected being the big toe, which is painful, especially when walking.

Gout attacks improve, and what you can do is adjust your diet to reduce blood uric acid levels and use anti-inflammatory drugs to control pain and inflammation.

To control the levels of uric acid in the blood, the rheumatologist or general practitioner may also recommend the use of drugs to block the production of uric acid, such as Allopurinol, or drugs to help the kidneys to eliminate the acid. uric acid by urine, such as Probenecid.

Main symptoms

Gout symptoms arise as a consequence of the deposition of uric acid crystals in the joints, resulting in intense joint pain that lasts for a few days and worsens with movement, in addition to increased local temperature, swelling and redness.

The pain, which most often starts at dawn, is intense enough to wake the patient up and lasts for about 12 to 24 hours, however, after the pain the person may feel discomfort in the affected joint, especially when moving, which can last a few days to weeks, especially if gout is not treated properly.

Any joint can be affected, however gout is more frequent in the lower limbs, especially the big toe. There can also be the formation of kidney stones and deposition of uric acid crystals under the skin, forming bumps on the fingers, elbows, knees, feet and ears, for example.

Learn to recognize the symptoms of gout.

How is the diagnosis

The diagnosis of gout is made according to the patient's clinical history, physical examination and complementary tests, such as blood and urine uric acid levels, in addition to radiographs.

The gold standard for the diagnosis of gout is the observation of urate crystals through microscopy.

Causes of Gout

Gout occurs as a consequence of hyperuricemia, which corresponds to an increase in the amount of uric acid in the blood, which can happen either due to increased production of uric acid or due to a deficiency in the elimination of this substance. Other causes of gout are:

  • Inadequate medication intake;
  • Excessive use of diuretics;
  • Alcohol abuse;
  • Excessive consumption of foods rich in protein, such as red meat, offal, seafood and legumes, such as peas, beans or lentils;
  • Diabetes;
  • Obesity;
  • Uncontrolled high blood pressure;
  • Arteriosclerosis.

Due to the large amounts of uric acid circulating, there is deposition of crystals of monosodium urate, which is the solid form of uric acid, in the joints, especially the big toe, ankle and knees.

The occurrence of gout is more common in overweight or obese people, who have a sedentary lifestyle and who have chronic diseases that are not being very well controlled. In addition, gout is more common in men between the ages of 40 and 50 and women after menopause, usually from the age of 60.

How the treatment is done

Gout treatment is basically divided into two stages: acute crisis management and long-term therapy. Treatment for gout attacks involves anti-inflammatory drugs that must be recommended by the doctor, such as ibuprofen or naproxen, for example, to relieve joint pain and inflammation. Another anti-inflammatory drug widely used to control pain and inflammation is Colchicine, which also acts on the level of uric acid.

Corticosteroid medicines, such as Prednisone, can also be used to treat joint pain and inflammation, however these medicines are only used when the person cannot take other anti-inflammatory drugs or when they do not have the desired effect.

In addition to these medicines, the rheumatologist or general practitioner can also prescribe medicines to control the levels of uric acid in the blood to prevent further attacks and prevent complications, such as Allopurinol or Probenecid. See more about treating gout.

It is also important to change eating habits, as it can directly influence the amount of circulating uric acid and, consequently, the deposition of crystals in the joint, and treat underlying diseases that can also favor the occurrence of gout when untreated, such as hypertension and diabetes, for example.

How to eat

To alleviate the symptoms of gout and prevent further attacks, it is important to change your eating habits so that uric acid levels are regularized.

In this way, one should reduce or avoid the intake of foods rich in purines, such as cheese, lentils, soy, red meat or seafood, as they increase the levels of uric acid in the blood. In addition, one should drink about 2 to 4 liters of water a day. See more details of diet to lower uric acid and relieve gout.

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