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What is it about ?
Gout is a rheumatic disease characterized by the deposit of uric acid crystals in a joint (usually the big toe) causing an inflammatory reaction. The inflammation makes the joint painful, red, hot, and swollen. We also speak of “podagre” or “gout on the foot”. Gout occurs in people with a high concentration of uric acid in the blood. The condition can also be the result of kidney problems and dehydration.
Where and how often?
Gout affects 5 to 28 in 1,000 men and 1 to 6 in 1,000 women. It is therefore more common in men than in women, often in middle age. Gout rarely occurs in women before menopause and in men under the age of 25.
How to recognize it?
The first symptom of gout is often a very painful inflammation of a joint at night. In 5 to 7 out of 10 people, it is the big toe. The ankle, knee, and other joints in the foot area are also commonly affected. Inflammation is less common in the joints in the upper part of the body. Exposure to cold, physical stress, alcohol or food containing a lot of “purines” (such as organ meats, game, etc.) can trigger a gout attack.
Gout is sometimes accompanied by a slight fever. The inflamed joint is red, swollen, and hot. In general, the slightest touch here is almost unbearable. In people who have had gout for a while, the build-up of uric acid crystals form lumps under the skin (tophi).
Gout is not caused by a bacterial infection. If the inflamed joint is located near a wound, the doctor should be seen as soon as possible. Bacteria can indeed enter the body through the wound and affect the joint!
How is the diagnosis made?
The doctor will ask you questions and perform a detailed physical examination. He’ll want to know if it’s the first time you’ve had an inflamed joint. He will also check to see if the pain is in other places or if you have other problems and / or if you are taking medication. He will eventually talk to you about your diet. It may be important to report recent infections or mention possible tick bites. The purpose of the examination is to rule out any sores, to make sure that it is an inflamed joint, and to examine other joints as well. A general examination can be useful.
A blood test is often done to determine the concentration of uric acid. The concentration usually increases with gout, but values are often low during an acute attack. If in doubt about the diagnosis, the doctor will take joint fluid for analysis under a microscope.
What can you do ?
An inflamed joint requires a quick visit to the doctor. In the meantime, the pain can be relieved with ice and possibly with a pain reliever such as ibuprofen.
If gout attacks are frequent, it may help to pay attention to your lifestyle. Try to lose extra pounds, increase your physical activity, and cut down on certain foods. Indeed, some products are rich in purines, which degrade into uric acid. These are meat (especially offal and game), fish, shellfish, alcohol (especially beer) and sugary drinks. In the same vein, it is better to consume dairy products that are low in fat. Eating foods that are lower in purines may help lower uric acid levels in the blood and reduce the frequency of gout flares. Avoiding purine completely isn’t possible, and that doesn’t make much sense either.
What can your doctor do?
To calm the inflammation, the doctor will prescribe anti-inflammatory drugs. If possible, a cortisone preparation is injected into the joint. In the event of frequent gout attacks, there are drugs that can reduce and ultimately stop the attacks, this is the basic treatment. For a gout attack, other drugs are prescribed than in the case of a basic treatment.
Want to know more?
- The food pyramid – Eat Move – Health Question
- Physical activity – Eat Move – Health question
- Alcohol, the point on your consumption – Stop or else?
- Non-steroidal anti-inflammatory drugs – CBIP – Belgian Center for Pharmacotherapeutic Information
- Ibuprofen – CBIP – Belgian Center for Pharmacotherapeutic Information
Are you looking for more specialized help?
- Find a registered dietitian – Professional Union of French-speaking dieticians
- Find a nutritionist doctor – Belgian Society of Nutritionist Doctors
- Alcohol aid – Le Pélican & Le center ALFA
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