Arthritis - Gout

Image is credited to 

http://almurshidimed.com

Hi!! Today, let's talk about Gout. What is gout? Gout is just another common type of arthritis. However, gout is not like osteoarthritis that was caused by wear and tear, or rheumatoid arthritis that is due to an autoimmune response. Gout is simply caused by increased uric acid levels in the body, that gradually form a needle-like crystal in the joints. Now, what is uric acid, and how does this happened?  Let Auntie explain to you.

Uric acid is a waste product produced from the metabolism of a purine by your liver. The process actually starts with your diet. For example, today you have a steak for lunch and seafood for your dinner. These foods, then been digested and converted to purines, lots of it. Too much purine will cause harm, so your liver converts those purines into uric acids. However, when you actually have liver or kidney problems, this where the problem comes in. 

You see, due to its high water solubility, uric acids tend to be excreted easily, via your urine. But, when you having kidney dysfunction or problem, it takes a longer time to fully excrete the uric acid. Thus, the uric acid starts to accumulate in the bloodstream, to the point it would penetrate the synovial membrane of your joint, especially your big toe. When it comes to this point, your body's immune system would detect the accumulated uric acids as a foreign substance that causes harm to the surrounding cells (in this case, the joints). Hence, inflammation, accompanied by excruciating pains, occurs.

Diagram 1 shows the flow of gout occurrence

What worst about gout is the excruciating pain that would wake you up in the middle of the night or after a long rest, especially at your big toe. Yes, gout does come and go, just like the other arthritis types. But, when it attacks you, the pain just unbearable. and due to the inflammation, the affected joint would swell, and become red and tender. 

For those who had liver damage or other problems, there would be abnormalities in some of the enzymes involved in the formation of uric acids. When your liver damaged, it tends to produce the enzyme involved causing the process of uric acid formation to accelerate and increase the uric acid level in the body.

Risk Factors

Diagram 2 shows the risk
factors of Gout

1) Being a man or menopausal woman

In the olden days, gout is also called as 'Disease of the Kings'. This is because, unlike osteoarthritis, the majority of gout patients are men. Women after menopause also are at risk of developing gout. There are some studies that believe that this is due to the influence of a hormone, estrogen, that plays role in eliminating the uric acid from the body by altering kidney function. Since men and menopausal had very little estrogen, this might be the reason for their risk. However, it does not mean the younger women won't develop gout, though it would be very rare.

2) Family history

Just like other arthritis, gout also tends to run in family genetics. So, if any of your close relatives have a history of gout, the chance of you develops gout is possibly high.

3) Diet and alcohol consumption

Like Auntie explained earlier on 'how gout is developed?', purine exists in many types of foods, but the amount differs from each of the food. Foods and drinks like red meat, seafood, animal organs, soda, carbonated drinks, gravy contain a high amount of purine and have a higher chance of developing gout. Uncontrollable consumption of alcohol also could lead to gout as it may damage both the liver and kidney.

4) Being overweight

Overweight could cause many health complications, including gout. This is because the fat-saturated under your skin and around your organs could disturb your kidney and liver function.