Gout is a painful type of arthritis that is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. Historical references to gout have been recorded as far back as ancient Egyptian times. It has often been called "the disease of kings" or "rich man's disease", especially during the middle ages to depression eras, because it was thought to be caused by a "rich" diet, heavy in meats. However, in recent years, this is no longer the case and is becoming more common possibly due to increased standards of living with more availability of food and dietary changes such as a rising trend of consumer preferences for “richer, sweeter and saltier foods”. Increased consumption of alcohol and sugary drinks, as well as the modern sedentary lifestyles are also contributing factors of this increased cases of gout. As for age, gout is usually a disease of middle aged and older men, and postmenopausal women. It is very rare in children and young adults.
Aside from being very painful during flareups, having gout syndromes also means increased risk of developing numerous conditions. In those with gout, uric acid builds up and forms painful crystals around joints, often affecting the big toe. Health problem linked to gout go beyond the joints, however. Excess uric acid can also damage kidneys, blood vessels, and other organs, and gout raises the risk for several disorders, including kidney and cardiovascular disease, as well as diabetes, depression, and sleep apnea – according to the Arthritis Foundation:
Kidney Disease and Kidney Stones. The buildup of uric acid crystals in the kidneys can cause problems that can range from reduced function to kidney failure. Damage is progressive, but the right treatment can often slow it down. A 2018 study published in Arthritis Research & Therapy reported that people with gout have a 78% higher risk of moderate kidney disease, which typically has no symptoms. The same study noted about 1 in 4 people with gout have this level of renal damage. Kidney stones, which form when uric acid crystals settle in the organs and block the urinary tract, affect an estimated 1 in 5 people with gout. People without gout who have higher than normal uric acid levels also have an increased risk of kidney stones, according to a 2017 American Journal of Kidney Disease published study. The higher the uric acid level, the higher the risk, the study found.
Heart Disease and Stroke. Research links gout to an increased risk of several types of cardiovascular disease, including heart attack, heart failure, and atrial fibrillation, or an irregular heartbeat. A 2018 Arthritis Care & Research study, for example, found that adults over the age of 65 have at least a double the risk of heart attack compared with those without gout. Gout also increases the risks for stroke and peripheral vascular disease. Researchers are not yet in agreement on exactly how gout increases cardiovascular disease risk. Ongoing body-wide inflammation driven by uric acid crystal buildup may damage blood vessels, but it is likely that several inter-related factors are also involved.
Diabetes. Women with gout are 71% more likely to develop type 2 diabetes; in men, gout increases the risk for diabetes by 22%, according to a 2016 Annals of the Rheumatic Diseases study. Excessive inflammation levels probably contribute to increased risk, along with disorders common to the two conditions, such as obesity, high cholesterol, and high blood pressure.
Depression. Gout in adults older than 65 is associated with a 42% increased risk of developing depression, according to a 2018 study published in Psychiatry Research. Again, the common link is not clear, but scientists suspect that chronic inflammation, which has recently been associated with depression, plays a role.
Sleep Apnea. People with gout are at twice higher risk of obstructive sleep apnea, a disorder characterized by frequent pauses in breathing during sleep, according to a 2018 Journal of Clinical Sleep Medicine study. Research published in 2019 in Arthritis & Rheumatology also found that people with sleep apnea have an increased risk of gout, which is highest in the two years following diagnosis of the sleep disorder. Like gout, sleep apnea also raises risk for obesity, diabetes, high blood pressure, heart attack, and stroke, and researchers think the two disorders share common mechanisms.
Unfortunately, gout cannot be cured but long-term conditions can be controlled with a modification of behaviors, change of diet, medicines, and anti-inflammation drugs to treat a flare-up. Lowering one’s uric acid levels is the key to treating gout. Certain foods such as limes, which contain high levels of citric acid, help to flush out uric acid in the body and is therefore helpful for those with gout. Add to that, some regular exercise and altering your lifestyle to avoid being sedentary will help in the control of gout conditions.
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