Mathew Thomas (name changed), a 37-year-old event management company owner from Kochi, Kerala, noticed swelling in his right knee joint, which was accompanied by intense pain. He initially attributed the inflammation to taking a knock on a hard surface. However, once the pain became unbearable and started affecting his daily activities, he decided to seek medical attention and was diagnosed with gout. “I didn’t know I had gout until my early 30s. The doctor examined the swelling and advised me to get a blood test done,” recalls Thomas. “On receiving the reports, he diagnosed me with gout, saying that the pain resulted from the accumulation of uric acid in my joints. I was at a loss and didn’t know what to do at first.”
Thomas has been living with gout for the last five years. He explains that while the pain mostly comes and goes, it’s so intense that he cannot even walk. In the worst cases, he can barely wear a shoe, and the irritation resulting from the pain makes it difficult for him to concentrate on his work.
Gout: How is it caused?
Gout, also known as inflammatory arthritis, is a condition where uric acid (waste product created during the breakdown of chemicals called purines) accumulates in the blood above normal levels, causing sharp needle-shaped crystals to form in the joints. “These crystals can cause intense pain and swelling, along with redness and tenderness,” says Dr Chethana D, consultant, rheumatology, Aster CMI Hospital, Bangalore. The most common area affected by gout is the big toe; however, it can also affect other joints like the wrist, knee, ankle and hand.
Consumption of certain high-protein foods (like red meat, sugary foods and alcohol) and shellfish, which contain purines — organic compounds that form uric acid when metabolized — can contribute to the onset of gout attacks.
Genetic predisposition may also play a role in the development of gout, explains Dr Raghavendra H, consultant rheumatologist, Manipal Hospital, Hebbal, Bangalore. “Individuals with a family history of gout may also develop the condition. In addition, certain metabolic disorders like diabetes, hypertension, etc., can also lead to gout,” he informs.
Measures to manage gout
While experts say that there’s no cure for gout, they suggest some simple steps to manage the pain and swelling:
♦ Maintain a healthy body weight
Overweight individuals can find it challenging to reduce the levels of uric acid in their blood. Additionally, obesity combined with elevated uric acid levels can make one highly susceptible to cardiovascular conditions, highlighting the importance of losing weight by being physically active. Simple aerobic exercises like jogging, running, cycling and swimming for around 25 minutes four to five days a week can help keep gout in check. “Exercise improves your metabolism, which in turn helps keep your uric acid levels under control,” says Dr Raghavendra.
♦ Limit purine in the diet
Avoiding or limiting purine-rich foods like red meat and mushrooms is a key step to controlling gout. It’s crucial to exercise moderation while having food items like eggs, fish, paneer and soybeans. Incorporating anti-inflammatory foods containing omega-3 fatty acids (such as fish oils and walnuts) into the diet can help reduce the risk of gout attacks.
♦ Lay off processed foods
Diving into packets of processed foods or drinking carbonated beverages on a regular basis can make one highly susceptible to a gout attack. Sugary foods or drinks contain fructose, which elevates uric acid levels in the blood. This, in turn, can cause or exacerbate pain without appropriate intervention.
♦ Ensure adequate hydration
Staying well-hydrated can help reduce uric acid levels. Drinking around two to three liters of water per day can help flush out excess uric acid from the kidneys, reducing the risk of crystal formation.
♦ Ease the discomfort with ice packs
Applying ice packs to the affected area can help alleviate pain and reduce swelling. Icing for about 15–20 minutes numbs the area, relieving discomfort associated with gout flare-ups. However, if the inflammation and pain persist, one should consult a healthcare professional.
♦ Ensure adequate rest
It’s important to rest and reduce pressure on the affected joint during a gout attack to prevent further irritation. Limiting movement and elevating the affected limb can provide some comfort.
