Gout is characterized by painful, swollen, and hot joints. It is particularly common in men over the age of 40. We explain what causes the disease and how it can be treated.
Overview: What is gout?
Gout is a metabolic disease in which too much uric acid builds up in the blood. Uric acid is a breakdown product of metabolism and is formed when the body breaks down so-called purines, which are ingested with food. Purines are contained in all body cells and foods and are necessary for the construction of new cells.
Uric acid is excreted via the kidneys. However, if it accumulates in large quantities, the concentration of uric acid in the blood increases. One speaks of Hyperurikämie. Uric acid crystals form, which are deposited in various parts of the body, such as joints, organs, tendons or bursae, where they lead to painful inflammation. An acute gout attack is imminent.
Depending on where the crystals are primarily deposited, there are three types of gout:
- joint gout: Joints in the hands and feet as well as the knee and elbow joints are particularly frequently affected. The affected areas are red, swollen and hypersensitive. If left untreated, joint inflammation can lead to permanent joint damage (arthritis).
- Soft tissue gout: Crystals are deposited under the skin and form small nodules. (e.g. ear cartilage, tendons, bursa)
- kidney gout: The uric acid crystals are deposited in the kidneys and can cause kidney stones or even complete kidney failure.
Attention: Gout is not always behind joint pain. Swelling and pain in large joints, such as the knee or shoulder, can also be symptoms of pseudogout. They are similar, but have completely different causes.
causes: How does the disease develop?
In most cases, the main cause of gout is an inherited metabolic disorder. Behind this is usually a malfunction of the kidneys, which does not excrete enough uric acid. This is called primary gout.
Other diseases or metabolic disorders can also be causes of hyperuricemia. Secondary gout occurs when, as a result, either the breakdown of uric acid is inhibited or too much uric acid is produced. For example, kidney disease or diabetes can cause reduced uric acid excretion. Leukemia patients and people who are fasting or undergoing a radical diet are also at risk, because their body’s own cells disintegrate particularly quickly, which means that more purines are released and the uric acid value rises rapidly.
If the uric acid level exceeds a certain value, an acute attack of gout occurs. Certain factors have a positive effect:
- excessive consumption of purine-rich foods, such as meat and legumes
- excessive alcohol consumption
- overweight
- high weight loss, e.g. B. by fasting
- Stress and heavy physical exertion
80 percent of gout patients are men between the ages of 40 and 60. Women usually only become ill when they reach retirement age. Researchers therefore suspect that women are protected by the female hormone estrogen until they reach menopause.
symptoms: Signs and course of the disease
The big toe often hurts during the first gout attack. (Source: Thinkstock by Getty Images)
An acute attack of gout literally tears those affected out of their sleep. Typically, pain begins at night and in the big toe (about 60 percent of cases). In about 10 percent of cases, the knee becomes inflamed first. The joints of the hand, especially the metatarsophalangeal joint (about 5 percent of cases), are less frequently affected. A so-called gouty finger is primarily caused by previous damage to the finger joint, e.g. B. as a result of arthritis favored.
The affected joint feels swollen, red, and hot. Extreme sensitivity to touch is striking. The attack is often accompanied by fever and can last for hours or even days if left untreated. It is not uncommon for the pain attack to be triggered by sumptuous food or copious alcohol consumption the night before.
The most common symptoms of an acute gout attack are:
- sudden, severe pain (usually at night)
- red or bluish discolored joint
- swelling
- skin feels hot
- extremely sensitive to touch and movement
- fever
After the first gout attack, it often takes months or even years before a new attack occurs. However, the symptoms should not be taken lightly. If the uric acid level remains permanently high and there is no adequate treatment, chronic gout can develop. The result is permanent deformation and the associated functional limitations of the joints.
Nodules, so-called gout tophi, can form under the skin – especially on the elbows, hands and feet. These are deposits of uric acid crystals. In their most dangerous form, the nodules form in the kidneys, where they can lead to impaired function and even kidney failure. Such a negative development of the disease is further promoted by a late diagnosis or inadequate treatment.
More on the subject: gout attack
treatment: Therapy for acute and chronic gout
During an acute gout attack, there are various measures to relieve the pain. Common home remedies are:
- Drink: Gout patients should drink at least 2-3 liters of fluids a day. The liquid promotes the excretion of uric acid in the urine. is particularly suitable nettle tea, which stimulates the metabolism and has an anti-inflammatory effect.
Our tip: Soak a cloth in the freshly brewed nettle tea, wring it out and wrap it around the affected joint for about an hour.
- Elevate: If the toe is affected, elevating the foot is often found to be pleasant.
- Cooling Envelopes: Quark wraps are particularly recommended in the event of a gout attack, because quark has cooling and anti-inflammatory properties. To do this, spread chilled quark a centimeter thick on a cotton cloth, place it on the joint and wrap it with another cloth. Leave the poultice on for 60 to 90 minutes.
- salt socks: If the toe is affected, a salt sock can relieve acute inflammatory symptoms. Dissolve 30g of table salt in 1 liter of warm water. Then dip a cotton sock in, wring it out and slip it over the affected foot. Pull a wool sock over it and leave the application on for about an hour.
Self-therapy with painkillers is not recommended under any circumstances. Aspirin in particular is not recommended, as this drug contains the pain-relieving active ingredient acetylsalicylic acid, which can increase uric acid levels. Instead, see a doctor who can help you medication, such as nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine or cortisone.
After an acute attack, therapy should be urgently continued. A low-purine diet, a healthy lifestyle and avoiding alcohol can bring the uric acid level back to normal and ideally stabilize it permanently in order to avoid further attacks and chronic gout. You can have your uric acid level determined by your doctor. If the uric acid level cannot be reduced naturally, the doctor can also prescribe appropriate medication. The active ingredients allopurinol or febuxostat have proven to be particularly helpful. They reduce the concentration of uric acid in the blood and restore the normal condition.
prevention: with a low-purine diet against gout
Gout can be prevented by eating a low-purine diet. (Source: Thinkstock by Getty Images)
An elevated uric acid level in the blood can often be traced back to an unbalanced diet. Fatty meat, legumes and alcohol are classic uric acid bombs. Eating habits that are typical of highly industrialized countries – it is not for nothing that gout is also referred to as a “disease of affluence”.
Anyone who has problems with gout or wants to prevent a gout attack should avoid foods with a high purine content. Meat, offal, certain types of fish such as salmon and herring, or seafood such as mussels, but also legumes contain a lot of purine and should therefore only be consumed in moderation. Experts advise against eating meat every day. Overall, consumption should be less than 600 grams of meat per week, according to the recommendation of the German Society for Nutrition (DGE). Low-purine foods include coffee, milk, rice, fresh fruit and vegetables, and grain products. Vitamin C is also used to prevent gout. It inhibits inflammation and the formation of uric acid in the body. Daily intake of 1500 milligrams reduces the risk of gout by 45 percent.
You should also avoid alcohol. In particular, beer and liquor intensify gout. Studies have also shown that soft drinks and juices also increase the risk of gout due to their high fructose content. Instead, it makes sense to drink plenty of water or tea. It should be at least two liters a day. Regular exercise and a normal body weight also counteract gout.
More on the subject: diet in gout
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