Gout is a metabolic disorder that primarily causes painful joint inflammation. The cause is too much uric acid in the blood , which is deposited in a crystal form under the skin. However, through constant change in diet and other lifestyle factors, uric acid level can be controlled and discomfort reduced.

Development of gout

In gout, the uric acid level in the blood is too high. Either because too much is being produced or because the kidneys are not getting enough. They form small crystals of uric acid, which are deposited in particular in the joints. At particularly high levels, an acute gout attack may appear with pain, redness, and swelling.

Uric acid is formed during the breakdown of purines. But they are also acquired with food, especially meat and other processed foods, but also with some vegetables.

Primary gout – congenital disorder

Most gout patients suffer from a congenital metabolic disorder. Next, doctors speak of a “primary hyperuricemia” or “primary gout.” In most cases, the kidneys do not excrete enough uric acid.

In rare cases, the body produces so much uric acid that the kidneys are overwhelmed. The cause is a genetic defect, the so-called Lesch-Nyhan syndrome that occurs mainly in children.

Secondary acquired gout disorder

In so-called secondary gout, other diseases cause excess uric acid. In leukemia, for example, the body’s own cells are massively destroyed. It releases large amounts of purines that accumulate in the blood.

Other diseases that cause increased uric acid production:

  • Some types of tumors.
  • Anemia.
  • Certain medications (cytostatics).
  • Radiation in the context of cancer therapy.

Conversely, the uric acid level also increases if not enough uric acid is excreted. This is the case with kidney disease or untreated diabetes.

Factors that favor gout include obesity, a diet rich in meat, fructose, and alcohol, as well as a lack of exercise.

Triggers of acute gout

An acute attack of gout occurs when the uric acid level exceeds a certain level. The main triggers are:

  • Excessive consumption of foods rich in purine, such as meat and sausages.
  • Excessive consumption of foods rich in fructose, such as sugary fruit juices.
  • Too much alcohol: Alcohol also increases uric acid levels. This is especially true for beer, which is also particularly rich in purine.
  • Excessive physical exercise: This produces lactic acid in the body, which is excreted by the kidneys and blocks the breakdown of uric acid.
  • Diuretics or laxatives: they thicken the blood when used in excess or for a long time. This increases the uric acid concentration.

 How long does a gout attack last?

The duration of the gout attack can last for days or even weeks. Then the symptoms slowly fade. However, prompt treatment can significantly reduce the duration of gout attacks.

Gout symptoms

The most common symptoms are severe joint pain. They first appear as an attack. If gout remains untreated, symptoms gradually worsen and the condition becomes chronic.

If the uric acid level exceeds a certain level, an acute attack of gout occurs. Symptoms are severe pain in individual joints.

Most commonly, the metatarsophalangeal joint of the big toe is affected, as well as other joints in the legs and feet. Less often it affects the hands and arms. If left untreated, a gout attack lasts from a few hours to a few days. Thereafter, the symptoms slowly fade.

Treatment for gout

A gout treatment should reduce excess uric acid in the blood to a healthy level. Doctors recommend 5.5 to 6.4 milligrams per 100 milliliters of blood as upper limits.

What you can do yourself

Much can be achieved through a healthy lifestyle, especially through an adapted diet. If this is not enough for gout therapy, medications can lower uric acid level.

Gout diet

To reduce uric acid level you can do a lot by yourself. Nutrition conversion plays a crucial role here:

Foods rich in purine only in small portions: Purines are among other things contained in the genetic material of all living cells. When it breaks down, it produces uric acid. This applies to both your own cells and food. Foods rich in slurry include meat (especially cold cuts), hot dogs, shellfish, and certain species of fish. Delicious food can lead to an acute attack of gout if gout is predisposed.

Cut back on alcohol

Excessive alcohol consumption is particularly problematic in gout disease. For example, alcohol slows the breakdown of uric acid and raises its levels. Even if you reuse alcohol on an exceptional basis, it can lead to a gout attack. Particularly critical is the beer.

Be careful with fructose

Fructose is not only found in fruits. It is also used to sweeten juices, yogurt, or other foods. The breakdown of fructose in the body improves the formation of purine. At the same time, sugar, like alcohol, inhibits uric acid excretion through the kidneys.

Reduce fat intake

Too much fat inhibits uric acid excretion. Therefore, gout patients should eat high-fat foods as little as possible. If possible, you should cover no more than 30 percent of your daily calorie intake with fat. This limit is quickly reached, because fat has the highest energy density of all nutrients.

Pay special attention to hidden fats in certain foods, such as hot dogs or packaged goods.

Lose weight

As you lose weight, your uric acid level will automatically drop. But beware: weight loss must be slow and controlled. Severe fasting can trigger an acute attack of gout.

Drink a lot of water

Nutritionists recommend drinking at least two liters a day, preferably bottled water or unsweetened tea. Fluid in the body helps keep uric acid levels low and supports the kidney’s filtering function.

Exercise but don’t overdo it

Exercise has a positive effect on the joints. Function improves and inflammatory symptoms are reduced. However, you shouldn’t be overly stressed about gout, as the resulting lactic acid slows down the breakdown of uric acid through the kidneys.

Gout cannot be cured with medicine. Once medications are discontinued, their influence on uric acid level is lost and it increases again, hence the importance of modifying your lifestyle to support recovery after suffering from gout.

What to do with a gout attack?

Long-term therapy is not suitable for acute gout attacks. It is primarily about relieving pain as quickly as possible. Particularly effective aid for gout is the recommendation of anti-inflammatory pain relievers.

 Non-steroidal anti-inflammatory drugs (NSAIDs):

Non-steroidal anti-inflammatory drugs (NSAIDs) are the first drug of choice in the treatment of acute gout. They do not contain cortisone. Patients with gout are mainly prescribed indomethacin and diclofenac. As a general rule, symptoms improve within a few hours.

Homeopathic help

A physical therapy aims to reduce existing discomfort and reduce pain. In addition, it is to prevent damage to the joints and poor positions in the case of a long-term illness.

  •  Heat and cold treatments can reduce gout pain in the joints.
  • Procedures for muscle relaxation reduce pain.
  • Physical therapy strengthens the muscles and relieves the joints.
  • Physical therapy and occupational therapy prevent or restrict movement restrictions and joint deformities.

Home remedies

Protect your joints : keep the affected joint stable. Do not expose it or make strong movements while you are in pain. You may even need bed rest.

Cool your joints : In addition, pain in affected joints can be relieved with cold compresses. This is sufficient, even a towel that has been soaked in cold water. Alternatively, you can cool sore joints with quark wrap. The quark stays cold longer than a wet cloth.

Ice packs, on the other hand, are too cold and can cause skin damage quickly. Cooling down shouldn’t take more than ten minutes at a time, and done several times a day.

Soak your feet : This relaxes your muscles and joints and reduces pain. As a bath additive, hay or chamomile flowers are recommended. Remember that the water must be lukewarm.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses. He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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