What is gout disease? What is gout? What are the symptoms? What are the stages of gout treatment? What people get this disease? Is gout dangerous? One of the most common rheumatic diseases is gout. Gout is generally an inflammatory disease that is caused by the rise of uric acid. This disease, which occurs due to excessive accumulation of uric acid in certain areas of the body, usually occurs in joints and bone connections. As uric acid rises, crystals are deposited in the joints of the body. If the crystals are deposited, there will be extensive destruction and the patient may not be able to use that organ. With the deposition of these crystals, they cause a feeling of warmth, pain, limited movement and swelling. Gout usually occurs in the areas of the big toe joints; But joints such as knees, elbows, shoulders, arms, and even ankles and heels are also at risk of this disease. Usually, the most common joints that are involved are small joints, including the big toe joint. After the big toe joint, the ankle joint is usually the most common joint that suffers from pain. Knee joints and other joints can also be affected by this disease. When the joint is involved, there is usually severe pain. The most common cause of gout is a genetic defect in an enzyme that removes uric acid from the body. If this enzyme is not available, uric acid will not be removed from the body. ### **What are the symptoms of gout?** - Existence of pain and swelling in the joint area, especially in the area of the big toe joint. - Inflammation and redness and shiny skin and scaling due to the accumulation of uric acid. - Warming the place affected by gout. - The joint affected by gout will be so painful that it will be impossible to touch and press. - In some cases, the person will have a mild fever. - Statistics show that the onset of this disease is often at night and during sleep, and a person may have less pain during the day. - Normally, gout disease appears very quickly and suddenly and causes pain and swelling. - After the initial attack, there is a high probability that the patient will have another attack. Of course, if the patient is examined and treated by a specialist doctor from the beginning of the disease, possible future attacks will be prevented. ### **What is uric acid?** Generally, when the body burns proteins, uric acid is produced as a waste product from this metabolism. This substance is normally eliminated from the body by the circulatory system and kidneys. But there are conditions that cause this substance to accumulate in certain parts of the body in the form of crystals and the kidneys are not able to purify them completely. Foods containing the amino acid purine are the main reason for increasing uric acid in the body. Protein foods, especially red meat, chicken and fish, are the main sources of purine amino acids. ### **Why is uric acid dangerous?** Accumulation of uric acid in the body and the formation of crystal masses stimulate the body's immune cells. In this way, immune cells identify uric acid as an invader and eat it. This causes the immune cells to secrete special chemicals called "leukotriene" and "prostaglandin". These two substances will cause pain and swelling in the joints and places where uric acid crystals accumulate. ### **Is gout dangerous?** Gout is a preventable and treatable disease. This disease, like other rheumatic diseases, has different stages of development. In the following, we are going to explain the things that affect gout. Generally, big toe pain will improve after a week with or without treatment. However, in 70% of cases, within the next two years, this pain reappears and recurs. Among the characteristics of gout pain, we can mention recovery and exacerbation periods. After a few years, the attack intervals become shorter when the number of attacks increases. The patient's pain may not improve, his symptoms may last longer and this pain may remain a constant state. If the patient's pain continues, he has entered the stage of chronic gout. ### Gout diagnosis In general, the diagnosis of gout disease is usually by observing gout attacks. In this disease, one body joint is usually involved and the simultaneous involvement of several joints is less like the situation seen in rheumatism. Tests that are used to diagnose this disease include: **joint fluid test** The doctor may use a syringe to draw fluid from the affected joint. When this liquid is examined under a microscope, it shows whether there are crystals in it or not. **Blood test** The doctor may prescribe a blood test to check the amount of uric acid in the blood. Note that some people who have high uric acid never get gout and also some people get this disease even though they have normal uric acid. Plain radiographs are sometimes used to help diagnose gout. In plain radiography, the accumulation of tofus around the joints may be seen or joint destruction may be observed. ### prevention of gout - Continuation of high consumption of water and useful liquids - Stopping or limiting the consumption of alcoholic beverages - Supplying the body's daily protein needs from low-fat sources - Reducing the consumption of red meat - Maintaining and maintaining weight within the normal range as well as avoiding weight gain ### **Effective factors in gout** There are various factors that cause gout to progress to some extent and become dangerous. - #### **Age and gender:** Age and gender are one of the factors that play a big role in the progress of gout disease. Studies have shown that men produce more uric acid than women. But this does not mean that women are not at risk of this disease; Because the amount of uric acid production in menopausal women is almost close to that of men. - #### **Genetics:** The second most effective factor in the development of gout is genetics. If there is a history of gout in your family's medical records, your chances of getting this disease will undoubtedly increase. - #### **Eating habits:** Eating habits play such a big role in the development of this disease that it can be considered the most important factor in the development of gout. As mentioned, excessive consumption of foods containing purine amino acid increases the production of uric acid in the body. It is interesting to know that people who use alcohol will cause a disturbance in the elimination of uric acid from their body. - #### **Effect of drugs on gout disease:** Research shows that some drugs also play a role in the production of uric acid in the body. For example; Medicines containing salicylate or diuretics increase the production of uric acid in the body. - #### **Weight:** Another important point is the direct relationship between weight and uric acid production! Overweight people have a greater potential to produce uric acid due to their higher metabolism than lean people. Therefore, people who are overweight are more at risk of developing gout. - #### **Underlying diseases:** The things mentioned above were the set of effective factors that played a role in the progress of gout in healthy people (people who do not have any underlying diseases). But those people who suffer from health problems and underlying diseases (kidney failure, high blood pressure, hypothyroidism, diabetes, etc.) are very at risk of developing gout. Because they are less able to remove waste materials such as uric acid from their bodies. ### **complications of gout** - **Relapsing gout:** In general, some people may have gout attacks several times a year, and if left untreated, this disease causes severe damage to the joints. - **Advanced gout:** If gout is not treated, grains called tophi may form under the skin of people, which are actually urate crystals that accumulate in different parts of the fingers, hands and feet. - **Kidney stones:** Urate crystals can sometimes accumulate in the urinary tract and lead to the formation of kidney stones, which can cause problems. ### **Home Remedies for Gout** Home treatment of gout can be done as we have presented to you. Gout can be treated with over-the-counter or prescription drugs. There are also non-medicinal methods that can be used to relieve, prevent and even cure gout. - Stop consuming foods containing "purine" until the end of the disease period. - Drinking 2 to 4 liters of water per day. - Avoiding and avoiding stress. - Avoiding drinking alcohol and even sugary drinks like soft drinks, until the end of the disease period. - Special exercises and foot massage or any joint affected by gout. - Cooling the joints. - Not putting pressure on the joints and keeping it high. - Weight loss. - Use of non-steroidal anti-inflammatory drugs such as naproxen, ibuprofen, colchicine or corticosteroids. - Also drugs that are prescribed only with a doctor's prescription, such as "Indomethacin". ### **When should we see a doctor?** If you feel or experience sudden and severe pain in a joint or joints, you should see a doctor. Ignoring the symptoms of gout leads to the loss of the normal state of the joints and their immobility. ### Last word: It is recommended not to use drugs such as "Probenecid" or "Allopurinol" during the peak of gout attacks! Because the use of these drugs can aggravate joint inflammation. These drugs help the body to produce less uric acid or eliminate uric acid better and faster. —————————————————————– Ways of communication with Dr. Majid Ghorbanzadeh The Instagram page of Dr. Majid Ghorbanzadeh Aparat channel of Dr. Majid Ghorbanzadeh The show channel of Dr. Majid Ghorbanzadeh —————————————————————– Knee pain and factors affecting it Arthritis and its treatment methods Diagnosis and treatment of back and neck disc