But because it is not the only joint that is affected, the term "gout" has now been abandoned.
What causes the disease - Factors that trigger it
Gout is caused by the deposition in and around the joints in the form of crystals of a uric acid salt called monosodium uric acid. The formation of these crystals is due to a large increase in the levels of uric acid in the blood (hyperuricaemia). Uric acid is a normal product and comes from the breakdown of purines contained in some foods, and is excreted by the kidneys. Hyperuricemia is due to either increased uric acid production or decreased renal excretion or a combination of both.
WHO DOES IT OFFEND?
It affects men much more often than women and in fact in a ratio of 5: 1, while it shows its highest frequency after the fifth decade of age.
HOW THE DISEASE MANIFESTS ITSELF
A long period of asymptomatic hyperuricaemia usually precedes the onset of the first episode of acute gout.
It has been estimated, however, that only 10-15% of people with persistent and severe hyperuricemia eventually develop gout after decades. The answer to this is not known. It is known, however, that certain factors favor the development of acute gout.
One such factor is the sharp increase or decrease in serum uric acid and synovial fluid levels, which results in the precipitation or release of monosodium urea crystals into the joint. Such a rapid change in uric acid levels is caused by:
- from repeated minor injuries to a joint
- from heavy alcohol consumption
- from medicines (some diuretics, small doses of aspirin, allopurinol)
- from high consumption of foods rich in purines
The first episode of acute gout is usually found at the base of the big toe (metatarsophalangeal joint). Joints that are also commonly affected are the knees, ankles and torso, while the wrists, elbows and wrists are less commonly affected.
The main clinical features of acute gout are:
Pain: The intensity of the pain varies from mild to very intense. As a rule, the pain is really so sharp and intense that the patient typically states that he has difficulty or can not walk at all or that he can not bear the weight of the bed linen, because often the onset of acute arthritis is observed at night.
- Swelling of the joint
- Redness
- Heat
- Intense sensitivity
An episode of acute gout usually resolves, even without treatment, within a week or two, only to reappear after weeks, months or even years. In untreated cases, the natural course of gout varies from mild pain episodes that subside within a few hours ("minor attacks") to recurrent acute arthritis episodes lasting 1-2 weeks.
In the early stages of acute gout the episodes are sparse and the intervals between attacks sometimes last for years. However, over time and without treatment, the attacks become more frequent, more prolonged and involve more joints. It is characteristic that in the intervals between acute gout attacks all joints, including those affected, are symptom-free.
As time goes on, if the appropriate treatment is not applied, the disease progresses to its chronic form , ie to chronic gout. This form usually settles after 10 or more years of recurrent gout and affects many joints. The transition from acute recurrent gout to chronic gout occurs when the intervals between seizures are no longer pain free. The affected joints are permanently painful and swollen, although the severity of these symptoms is much lower than in acute gout attacks.
If the patient is still left without proper treatment, arthritis attacks and even quite often continue to occur in this condition of chronic pain. The intensity of chronic pain also increases steadily over time and until proper treatment is applied. Catastrophic joint damage and eventually deforming polyarthritis also develop slowly. Usually in this form, during the examination of the patient, swellings are found near the joints or in other places, such as in the earlobe, which are called tufts and are nothing but accumulated urinary crystals.
DIAGNOSIS OF THE DISEASE
Diagnosis of gout is made when characteristic monosodium urea crystals are detected in the synovial fluid or when there are lumps that have been chemically analyzed or examined under a microscopic light microscope to show the presence of monosodium urea crystals.
Cultivation of synovial fluid for germs during inflammatory joint infection must also be negative to rule out septic (bacterial) arthritis that may have the same appearance but require a completely different treatment.
WHAT ARE THE COMPLICATIONS?
The complications of the disease are ultimately the destruction of the joints, but the complications of chronic hyperuricaemia are equally important as they can manifest from the kidneys (urolithiasis, renal failure up to the final stage), from the cardiovascular (hypertension, heart attack). Because patients with hyperuricaemia usually have other comorbidities such as high blood sugar, cholesterol, triglycerides, they are obese and with overloaded blood vessels and because urinary tract can directly or indirectly contribute to the worsening of these conditions requires close monitoring and treatment.
Uric acid
Like many other health problems that we often discover from an elevated blood test, uric acid and its values depend heavily on our diet.
It was also called the disease of the kings or the disease of the rich precisely because it afflicted them especially because of the "fine" but rich in meat, alcohol, sugar and fats, diet, which they did and which has been associated with an increase in uric acid in the blood and extension with the onset of gout (gout). As uric acid is produced in our body during the breakdown of purines, which we get mainly from proteins, seafood, sweets, etc. It is reasonable that if we modify our diet and our lifestyle in general we increase the chances of reducing both the uric acid circulating in our blood and that deposited in our joints and kidneys causing various problems.
The diet and the changes that will help us
Usually gout, which is due to the increased uric acid circulating in the body, causes unpleasant seizures, which are mainly accompanied by pain and discomfort. According to experts, when the acute symptoms subside, uric acid can be controlled through lifestyle changes. Here's what to do:
- * Try to lose weight as increased uric acid is associated with obesity and increased calorie prevention . In addition, the lighter one is, the less strain one has on one's joints, anyway.
- * Remove from our diet or significantly reduce the amount of foods that contain purines . Such are: The offal (liver, kidneys), the anchovy, the mackerel, the pea, the beer, the dried beans, the mussels, the trout, the sardines, the pike, the herring, the almonds, the taramosalata, the tuna , hunting and meat from small animals (eg hare, goat) etc.
- * Reduce, and if possible completely stop, alcohol . Especially sweet drinks such as beer and liqueurs should be avoided.
- * Drink plenty of water .
- * Eat plenty of vegetables, fruits and whole grains.
- * Avoid spices, sugar, processed carbohydrates and fat .
- * Avoid a lot of meats and cold cuts in general .
- * Choose dairy low in fat .
- * Let us also keep in mind that when we have a gout crisis it is advisable to avoid fatigue and walking , so that there is no additional strain on the joints.
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