Complications Of Gout, Symptoms and Treatment

What do David Wells, Jared Leto, Maurice Cheeks, and Benjamin Franklin all have in common? Gout. What is gout? I'm going to give you a deep dive into the complications of gout including symptoms, and treatment.

What Is Gout?

David Wells, the left-handed pitcher who has played for the New York Yankees, the Toronto Blue Jays has described his first gout attack. He said that he just kind of woke up one morning, started walking and took one stride, and then he started to scream in a high falsetto tone like a six-year-old girl. Then he states that he fell to the ground and started grabbing his left, big, painful toe.

What can make a strong star athlete fall to the ground and scream in pain? Gout can do it. What is gout? Gout is a type of arthritis or joint inflammation.

It occurs in some people who have elevated levels of urate, or uric acid. Now, just because you have elevated levels of uric acid, that does not necessarily mean that you will have gout. In fact, two-thirds of people with elevated uric acid have no gout. But in the patients who do, this uric acid forms into crystals that deposit in the tissues and in the joints.

With my patients who have these crystals in the joints, some of them have described it like having shards of glass inside your joint stabbing you. When these uric acid crystals form in the joints, they trigger an inflammatory reaction which causes pain, swelling, and redness of the joint.

Gout can occur in any joint, but it's typically present in the big toe, which is what David Wells described.

Gout Symptoms and Risk Factors

What are the risk factors for gout? Chronic kidney disease is a risk factor, which explains why I have so many patients with gout. Also, hypertension or high blood pressure is a risk factor.

Obesity, taking certain medications that increase the levels of uric acid in the blood such as diuretics can be a risk factor, consuming excessive amounts of alcohol like beer and wine.  Other risk factors include consuming excessive amounts of meats and seafood, as well as non-diet sodas with high fructose syrup.

Do you know who has been portrayed in paintings eating rich meats and drinking wine? Henry the eighth of England. Yes, the same Henry the eighth who was in the royal family of Prince Harry and Duchess Meghan Markle.

History dictates that when Henry the eighth was not preoccupied with beheading his wives, he had multiple gout attacks. In fact, it's because of Henry the eighth that gout got the nickname the disease of kings.

Complications of Gout

Indeed, Henry the eighth of England was a complicated character, but let's talk about the complications of gout. Kidney stones. When there are elevated levels of uric acid in the urine, it can cause a crystal formation in the urine, which can lead to uric acid kidney stones. I actually go into a great amount of detail about kidney stones in my YouTube video called Kidney Stones Explained.

Another one of the complications of gout can be tophaceous gout. When patients have gout over the years, recurrent gout flares, and a persistently elevated level of uric acid, they can develop chronic tophi, which develops when the uric acid crystals form these large conglomerations that can be under the skin, on the bones and the cartilage. The tophi typically are not painful, but they can get infected and have an acute inflammation which causes pain.

Gout Treatment

What is the treatment of Gout? The most immediate treatment of gout is to take care of the pain and inflammation. How do you treat inflammation? With anti-inflammatory drugs.

Your doctor can prescribe steroid-containing anti-inflammatories such as prednisone, which can be taken by mouth short-term. Also, you can be given steroid injections inside of the affected joint. You can also be prescribed nonsteroidal anti-inflammatory drugs, like Ibuprofen, Motrin, Advil or Indomethacin.

The key is to have a discussion with your physician. Find out if it is safe for you to take these anti-inflammatories. If you are a patient with kidney disease or ulcers, or if you are predisposed to bleeding easily, then NSAIDs may be contraindicated in you.

Colchicine can be used to treat gout. Colchicine is a medication that helps to slow down or to stop inflammatory cells from migrating to that joint. So, colchicine is a drug that can be taken for the immediate treatment of gout. Colchicine does have certain side effects in certain patients. It can cause nausea, vomiting, and diarrhea.

So yes, steroids, NSAIDs, and colchicine can all be used to treat the inflammation and the pain of gout. And there's something to be said about the pain that gout causes. Founding father Benjamin Franklin, who has been credited for inventing bifocals and discovering electricity also had gout. History reports that his pain from gout flares was so severe that he would actually have to miss many meetings about the Declaration of Independence.

How To Prevent Gout

Another part of the treatment of Gout is prevention or prophylaxis. You can prevent recurrent gout attacks by decreasing the amount of uric acid in the blood. This can be done through certain medications such as Uloric, Allopurinol, or Probenecid. Again, a consultation with your physician will let you know which medication is right for you.

This ends my general overview on gout, including complications of gout, treatment of gout as well as causes and symptoms.

Please comment down below. Let me know what your experiences have been with gout.  Let me know what other topics you'd like me to discuss.  Also, make sure that you go to your doctor. Find out if you are at risk for gout.

Find out which treatments are safest for you and what lifestyle changes can help you to prevent attacks. As always, I want you to prioritize yourself, take care of you, and do your best to live your healthiest, happiest life.