GOUT: The rich man’s disease

The festive season is here and as usual, most of us often let down our guards and indulge, then face the consequences of our indulgence later. This may not be the kind of advice you want to hear at this time, but nevertheless it shall be stated.  If you over-indulge in alcohol and grilled meat (nyama choma), you might end up with a sudden and unexpected acute pain. It will most likely be late in the night after a whole day of indulgence, and your big toe will feel like it’s on fire. Even the weight of the bed sheet on the toe will feel intolerable. And, it will not just be that toe, it could be in your feet, ankles, knees, elbows, hands, wrists and fingers. Overindulgence in meat, seafood and alcohol, particularly beer, will put you at the risk of gout. Gout affects both males and females but is more common among males because they tend to have higher uric acid levels than women. It affects the joints, which become hot, swollen and tender. The good news is that gout is treatable and there are ways to reduce the risk of recurring. It’s imperative that you call your doctor if you experience sudden, intense pain in a joint, since gout that goes untreated leads to worse pain and joint damage eventually.

WHAT CAUSES GOUT?

Gout is caused by excessive uric acid in the blood that may be deposited in joints and other tissues of the body. Uric acid is a breakdown product of purines that are found in all cells, as well as in many foods, such as meat, dried beans, asparagus, mushrooms and gravy. The uric crystals accumulate in your joints, causing inflammation and the intense pain of a gout attack. Uric acid normally dissolves in your blood and passes through your kidneys into your urine. However, sometimes your body either produces too much uric acid or your kidneys excrete too little uric acid. In such cases, uric acid can build up, forming sharp, needle-like urate crystals in a joint or surrounding tissue and cause pain, inflammation and swelling.

High levels of uric acid in your body make you susceptible to gout. A lifestyle of indulging in excessive alcohol, that is two drinks a day for men and more than one for women can increase the risk. In addition, conditions such as diabetes, high levels of fat and cholesterol in the blood (hyperlipidemia), and narrowing of the arteries (arteriosclerosis) can trigger gout. Some of the drugs used to treat hypertension and low-dose aspirin can also trigger gout by increasing the levels of uric acid in the body. If someone in your family has gout, you’re most at risk of developing it.

DIAGNOSIS…

A doctor may use a needle to draw fluid from the affected joint. The fluid can reveal urate crystals under a microscope. He may also do a blood test to measure the uric acid level in your blood. While some people never experience gout signs and symptoms, others may suffer several times each year. There is a consolation though; medication helps prevent recurring gout attacks. A major complication is when gout goes untreated as it may cause deposits of urate crystals to form under the skin in nodules called tophi. These can develop in several areas like your fingers, hands, feet, elbows, achilles tendons and along the back of your ankle.

PREVENTING GOUT…

Choosing the right diet helps prevent gout. Reducing your intake of foods that are high in purines, such as animal products, helps control your body’s production of uric acid. So limit your intake of meat, poultry and fish. Alcohol interferes with the elimination of uric acid from your body so limit its intake, and particularly beer. If you are overweight or obese, try and lose weight but not through fasting or through rapid weight loss as these promote a gout attack. Instead, drink plenty of fluids to help flush uric acid from your body. You should aim at eight to 16 cups of fluids daily, with at least half of these being water. There is evidence that drinking four to six cups of coffee a day lowers the risk of gout in men.

TREATMENT…

Gout is usually treated with medication. There are medications for different roles: to treat attacks, prevent gout complications, block uric acid production, and improve uric acid removal. Don’t wait to treat the disease, instead strive to have a healthy lifestyle. Prevention is always better than cure.