Gout: A systematic study.

Gout. A sense of fear creeps into you, does it, when you hear the word?

Nothing to worry about, readers, by the end of the article, you’d be familiar with the keyword and
everything related to it, and you’ll feel assured.

Let’s start with the process of knowing what gout is. Gout is a form of inflammatory arthritis that
develops in some people who have high levels of uric acid in the blood. According to the medical
terminology, uric acid is produced when the body breaks down a chemical called purine. Purine occurs
naturally in your body, but it's also found in certain foods. Uric acid is eliminated from the body in urine.

What are the symptoms of gout?

 Intense joint pain: It usually affects the larger joint of the bigger toe. The pain could also
develop in ankles, elbows, wrists and fingers. The pain is severe in the initial hours, that persists
for about 4-12 hours. There is severe discomfort in the areas mentioned, and if it persists, over a
longer period of time, then one should consult the doctor.

 Limited movement/motion: One usually finds it hard to move joints, causing greater
discomfort.

 Inflammation and redness: The affected areas, usually the joints, become swollen, turn red and
warm, usually tender in nature. The swelling gradually increases.

 Discomfort over a period of time: The pain in the joints prevails over a period of time, and there
is prevailing discomfort in the joints.

 Mild fever and fatigue: There are signs of mild fever and fatigue during gout, and shouldn’t be
ignored.

Diagnosis of gout by a doctor usually involves the checking of joints for intense redness and swelling,
and how frequent the pain is. Tests to help diagnose gout may include:

 Joint fluid test. The doctor may use a needle to draw fluid from your affected joint.

 Blood test. The doctor might recommend a blood test to measure the levels of uric acid and
creatinine in the blood. However, blood tests are misleading sometimes. Some people have high
uric acid levels, but never experience gout. There are people who have lower levels of uric acid
and yet are susceptible to gout.
  X-ray imaging. Joint X-rays can be helpful to distinguish other forms of diseases related to
inflammation.

 Ultrasound. Musculoskeletal ultrasound can detect urate crystals in a joint or in a tophus.

What are the risk factors for gout?

 Men between 40 and 50 years old and post-menopausal women are more likely to develop
gout.

 Studies have shown that males have higher chances of developing gout, in comparison to
females.

 Family history. It is hereditary too, and so if anyone in your family suffers from gout, there are
high chances of it being passed off to off springs.

 Diet. Eating too much purine-rich food raises your risk for gout. Red meat, organ meat, and
certain fish contain a lot of purines.

 Drinking more than two drinks a day puts you at a higher risk of gout.

 High blood pressure, kidney disease, thyroid disease and diabetes can also lead to gout, if not
monitored.

Food and diet.

 Complex carbs. It is advisable to consume more fruits, vegetables and whole grains, which
provide complex carbohydrates.

 Juices and beverages: Avoid foods and beverages with high-fructose corn syrup, and limit
consumption of naturally sweet fruit juices.

 Water: It is always advisable to stay well hydrated. Drink at least 8 glasses of water, to stay
hydrated.

 Fats: You might want to listen to your doctor and avoid the consumption of high fat dairy
products & red meat. One should avoid cakes and other baked products, which increase the
risks.

 Proteins: Focus on lean meat and poultry, low-fat dairy and lentils as sources of protein.

 Overweight: Studies have proven that the increase in weight can make a person vulnerable to
gout attacks. Losing weight lowers the probability of catching a gout, and thus much focus
should be given to diet, which in turns helps lowering the weight of the body.
  Alcohol: Beer and distilled liquors are associated with an increased risk of gout and recurring
attacks. Thus, one should refrain from consumption of alcohol during this period. Even
consumption of wine isn’t healthy.

 Coffee: The moderate consumption of coffee is considered to be healthy and has been
associated with lower risks of gout. However, more consumption of coffee isn’t advisable. Also
over consumption of caffeine can leader to other medical conditions.

 Vitamin C: It has been proven that consumption of Vitamin C leads to decrease in the levels of
uric acid. Thus, a Vitamin C tablet might prove worthy. Consulting a doctor is advisory.

 Exercise and hitting the gym: Due to adverse effects to joints, it is not advisable to engage in
any form of physical activity. Due to the inability of movement of muscles, the situation worsens
due to the movements while exercises. Complete bed rest is a necessity.

 Eggs: Eggs are okay for consumption as long as limited to 2-3 per week.

 Vegetables: Kailan, cabbage, beetroot are okay for consumption. Whereas, vegetables like
cauliflower, spinach and mushrooms should be avoided.
 Fruits: Oranges, tangerines & papaya are advisable and proven to be healthy . Apples can also
be consumed but in limited quantity.

What to avoid during gout?

It is essential that we take good care of ourselves, and avoid the consumption
 Shrimps, lobster and fish products should be avoided at any cost.

 White bread, white rice, pasta, sugar and other refined carbohydrates should be limited.
 Stay away from processed food like chips, cream etc.

 Sugary beverages are harmful and one should refrain from its consumption.

 The consumption of alcohol should be limited.

According to an article on mayoclinic.org a properly planned diet would be

similar to this:

Breakfast

 Whole-grain, unsweetened cereal with skim or low-fat milk

  1 cup fresh strawberries

 Coffee

 Water

Lunch

 Roasted chicken breast slices (2 ounces) on a whole-grain roll with mustard.

 Mixed green salad with vegetables, 1 tablespoon nuts, and balsamic vinegar and olive oil
dressing.

 Skim or low-fat milk or water.

Afternoon snack

 1 cup fresh cherries

 Water

Dinner

 Roasted salmon (3 to 4 ounces)

 Roasted or steamed green beans

 1/2 to 1 cup whole-grain pasta with olive oil and lemon pepper

 Water

 Low-fat yogurt

 1 cup fresh melon

 Caffeine-free beverage, such as herbal tea.

Home remedies:
There are people who’d prefer home remedies over medications. So let us go through that as well. Note
that, these are only proposed for temporary relief and if the problem persists, it is advisable to stick to
medication. Also, please consult the doctor before you try any of the below mentioned methods, which
otherwise might turn toxic.

Apple cider vinegar, lemon juice, and turmeric: are highly recommended during gout.

Nettle tea: Studies have shown that, stinging nettle is an herbal remedy for gout that may reduce
inflammation and pain. To try this tea, brew a cup by boiling water. Steep 1 to 2 teaspoons of dried
nettle per cup of water. Limit to 3 cups per day.
Magnesium: It is a dietary mineral. Try taking magnesium supplements , but read label directions
closely.

Ginger: Ginger is a culinary food and herb prescribed for inflammatory conditions. Its ability to help gout
is well-documented.

Make a ginger compress or paste by boiling water with 1 tablespoon of grated fresh gingerroot. Soak a
washcloth in the mixture. When cool, apply the washcloth to the area where you’re experiencing pain at
least once per day for 15 to 30 minutes.

Take ginger internally by boiling water and steeping 2 teaspoons of gingerroot for 10 minutes. Warm
water with apple cider vinegar, lemon juice, and turmeric

Hibiscus: Hibiscus is a garden flower, food, tea, and traditional herbal remedy. It has been known to
reduce the levels of uric acids.

Apples: Natural health sites may recommend apples as part of gout-reducing diets. It contains malic acid
which helps in reduction of levels of uric acid. Limit to eating one apple a day, not to be confused with
the famous phrase that it keeps the doctor away, but that, it doesn’t add to the sugar level.

Bananas: Bananas are thought to be good for gout because they’re rich in potassium. However, they
also contain sugars like fructose which might trigger gout. So consult before consumption.

Cherries: If you like cherries, then there’s a good news for you. It is advisable to consume cherries,
which help in reducing the risk of gout.

Treatment:

Treatment for gout usually involves medications. It is prescribed by the doctor after going through the
conditions and its severity.

Medications to treat gout attacks

Drugs used to treat acute attacks and prevent future attacks. The medicines mentioned below are well
researched and used. The sources for these medicines include several research papers, youtube videos
and consulting a family doctor.

 Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include over-the-counter options such as

ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), as well as more-powerful
prescription NSAIDs such as indomethacin (Indocin) or celecoxib (Celebrex).

However, NSAIDs carry risks of stomach pain, bleeding and ulcers.

  Colchicine. Your doctor may recommend colchicine (Colcrys, Mitigare), a type of pain reliever that
effectively reduces gout pain. The drug's effectiveness may be offset, however, by side effects
such as nausea, vomiting and diarrhea, especially if taken in large doses.

After an acute gout attack resolves, your doctor may prescribe a low daily dose of colchicine to
prevent future attacks.

 Corticosteroids. Corticosteroid medications, such as the drug prednisone, may control gout
inflammation and pain. Corticosteroids may be in pill form, or they can be injected into your joint.

Corticosteroids are generally used only in people with gout who can't take either NSAIDs or
colchicine. However, the side effects include increase in the levels of blood pressure.

 Medications that block uric acid production. Drugs called xanthine oxidase inhibitors (XOIs),
including allopurinol (Aloprim, Lopurin, Zyloprim) and febuxostat (Uloric), limit the amount of uric
acid your body makes. This may lower your blood's uric acid level and reduce your risk of gout.

In case of complexities, there is a medication that improves uric acid removal. These drugs, called
uricosurics, include probenecid (Probalan) and lesinurad (Zurampic). These medications should be taken
under strict guidance and after consulting a few more doctors, due to its severity and adverse side
effects. Uricosuric drugs improves the kidneys' ability to remove uric acid from the body. In this case,
the risk of gout is reduced but might lead to higher levels of uric acid in the urine. Side effects include a
rash, stomach pain and kidney stones.

The above methods are well researched. Do not consume any medicine before consulting the doctor. It
might lead to complexities.

Lastly, one should always be careful with the diet, take proper of health, stick to medications and get
plenty of rest. This can help in reducing the pain due to gout and serves a good pathway to providing
relief.

Sources used for this article include:

1) www.mayoclinic.org
2) Youtube videos on Gout and its prevention.
3) Articles on Medium.