Gout (Latin-gutta) literally means to drop. But what drops and where?
Let’s find out.
What is Gout?
Most people when thinking or describing gout refer to the painful and red mass which they find at their big toes. However, this is not entirely accurate.
Gout is any condition where the body’s uric acid levels are raised, period!!
Now this uric acid can cause kidney stones or an arthritic pain or gastric disturbances or may even remain asymptomatic.
However, for all practical purposes and for the discussion of this article, let’s stick to that painful annoying arthritis part.
What Causes Gout?
Look at this pathway.
Image Credit: igem.org
Okay, okay now don’t be scared like I was when I was in med school. It basically boils down to this
Proteins (from our diet) > uric acid is produced > excreted via urine
Now this is very important. If you have patiently read this article till now and you really want to know everything about this condition the above 3 point flowchart is all inclusive. It provides us with the causes, the method of diagnosis and the treatment.
How? We’ll just see.
1) If our protein intake is high, more uric acid is produced.
2) If due to any of the many reasons, one of which may be a genetic problem in the kidney (specifically- a defect in the oat-1 transporter. Don’t worry, you need not bother about this), more uric acid is retained in the body.
Research has found out that 90 percent cases are due to the second mechanism, the remaining, from the former
This genetic defect and hence gout is found more often in people belonging to a rich background and hence the historic term for the disease: Disease of the kings (be proud). Okay back to the topic
Symptoms of Gout
Image credit: wikipedia.org
This one picture captures the essence of more than 95 percent cases of gouty arthritis.
The pain is really as if a scorpion stings your toe. That too a red one.
Since red meat, alcohol, wheat gram and all articles increase protein content, pain is also increased after such a meal.
However this is only a layman’s generalization and gout can affect any and all parts of the body including elbows, hands, wrist and the like.
So don’t ignore pain at these sites as well, particularly when they increase after a good protein diet!!
Diagnosis of Gout
Not much to say here but for the sake of completion, that big old swelling on your big toe, the doctor will remove fluid from the same with a syringe. Scary, right?
Don’t worry, it’s done under local anaesthesia, so you won’t feel a bit of pain.
Your doctor will get a report in a few hours and if it looks something like this,
Image credit: wikipedia.org
Voila these are uric acid crystals (negatively birefringent) and the diagnosis is complete.
It’s worth mentioning here that blood Uric acid levels are not always elevated even in advanced disease and hence all this headache has to be undertaken
Treatment of Gout
Usually, lifestyle changes are more than enough.
Exercise, vitamin c supplementation, a low protein diet and all those things which your conscience tells you is good for you, really is good here in this case.
Sometimes when the pain is unbearable, your physician will prescribe a nsaid (aspirin) which is a common painkiller. Usually the pain subsides
The most common treatment in case of those who are chronic sufferers of gout includes allopurinol and the more recent febuxostat.
If you remember the above flowchart, these just act and prevent uric acid formation in one of the steps (xanthine oxidase inhibitors- again don’t worry, just nerdy stuff)
There are many more, including pegloticase, probenecid or colchicine, however this is not a forum for the discussion of such facts
In fact, in all entirety and responsibility, this and no other article on the internet is a substitute for you to start taking pills and not visit your physician. Only he/she is capable of the correct dose titration and combinations, so go get yourself checked up.
The above information is only meant to increase your awareness and should be thus used with caution.
Hope you guys liked it
Ps: what really did drop? (Remember the beginning). According to mediviel Latin scholars the crystals literally dropped from the blood into the big toe.