Gout: causes, symptoms & treatment

What Are the Symptoms of Gout?

Although gout can occur in many areas of the body, the big toe is most commonly afflicted. A gout attack can manifest in your big toe quickly, often in the middle of the night. The joint will swell, turn red, and feel warm to the touch, and will be extremely painful, even to touch it gently.

A gout attack usually lasts a few days and then subsides on its own if left untreated. But, multiple gout attacks could have long-lasting consequences for your joint.

What Causes Gout?

Gout is caused by a build-up of urate crystals in the toe joint. Uric acid is found in the blood and is a natural product of normal food digestion. The kidneys are responsible for eliminating uric acid through urination, but some people's kidneys don’t do this as effectively as others. Other people simply produce too much uric acid.

Why Are the Big Toes Usually Affected in a Gout Attack?

This is a very common and interesting question! .Liquid uric acid becomes a solid at low temperatures. Because the human body has a harder time regulating the temperature of its extremities, and that the toes are the smallest and farthest away from the heart, they get the brunt of it. Since excess uric acid solidifies in the cooler temperature parts of your body, they get deposited in the joints of your big toe most of all.

While some people are genetically predisposed to developing gout, here is a list of things that can contribute to attacks of gout:

Pre-existing Health Conditions

Certain health conditions, such as high blood pressure, obesity, diabetes, and stress.

Medical Treatments

Those who have undergone surgery or chemotherapy can be affected.

Medications, supplements, and Diet

Some medications and vitamins can make you more prone, such as aspirin, diuretic “water pills,” and niacin. Even diets high in red meat, shellfish, kidney, liver, red wine, and beer.

Diagnosing Gout

If you’re experiencing these symptoms, see your foot and ankle specialist right away. Your doctor will take your medical history and conduct a physical exam, and will probably take X-rays of your foot to see if the joint has sustained any lasting damage.

The doctor might take a fluid sample from the joint and have it sent to the lab for testing. A pathologist can then determine if crystals of uric acid can be found to help diagnose gout.

Treating a Gout Attack

To reduce the inflammation and relieve the pain in your joint, your foot and ankle specialist will prescribe either an oral or injectable anti-inflammatory. He or she may also inject a steroid into the joint to manage the irritation.

If you have one gout attack, however, it’s an indication that your body has an excess of uric acid in the blood. Your foot and ankle specialist will work with you to figure out what’s causing the excess and how to bring it down to healthy levels.

Medication can decrease your body’s production of uric acid during digestion and help your kidneys more effectively expel uric acid through urination. But you may also need to change your prescription drug intake or your diet and exercise routine.

Gouty Tophi Removal Surgery

Gouty tophi are nodules of crystallized uric acid normally found in the soft tissue, just under the skin. 

When the tophi are small you may not even notice them, but as they grow they can become painful, restrict joint movement, and in rare cases, cause infections. While these nodules are often harmless and can be treated with medication, tophi removal surgery may be recommended in advanced cases.

The link between gout and heart disease

The connection between gout and cardiovascular disease is important for patients and healthcare professionals to be aware of. Even if a patient is already undergoing treatment for their heart disease, such as statins, their risk of cardiovascular mortality is still increased.

Uric acid levels associated with gout are also linked to an increased risk of cardiovascular disease, including heart attacks, strokes, and heart failure. In addition, people with gout often have other risk factors for heart disease, such as obesity, high blood pressure, and diabetes. Therefore, it is important for people with gout to manage their condition and reduce their risk of developing heart disease by maintaining a healthy weight, controlling their blood pressure and cholesterol levels, and avoiding smoking and excessive alcohol consumption.