Gout in the spotlight

Gout is one of the oldest known diseases. Hippocrates, the Greek scientist who lived 300 years before our era and is considered the father of medicine, described the disease as the result of too much mucus that descends to the big toe and causes a painful inflammation. That story later turned out not to be entirely true. Yet numerous misunderstandings surrounding gout persist to this day.

Gout is a form of rheumatism – GOOD

Rheumatism is a term often used for any pain in the bones, muscles and joints, in fact rheumatism is a collective name for more than 200 types of rheumatic diseases, including gout. Gout is caused by uric acid crystals in the joints. Uric acid is a normal waste product that circulates in the blood and is continuously excreted through the urine. The uric acid concentration in the blood is kept low in this way, so that the uric acid remains dissolved. However, some people do not excrete enough uric acid or they produce too much, causing higher levels in their blood. However, too much uric acid in the blood encourages the formation of crystals. These uric acid crystals can enter and accumulate in the joints. This causes inflammation with pronounced swelling and a lot of pain.

Gout always starts in the big toe – WRONG

In nine out of ten cases, gout starts with severe inflammation in the big toe . The attack usually begins at night and the affected joint is red, glowing and extremely painful. Touch or even a sheet or blanket on the toe is usually not tolerated. Usually the doctor is called immediately.
But not all gout attacks follow this typical pattern. In 10 percent of cases, gout starts in another joint and people do not always think about the disease. If the gout attack occurs in a wrist or knee joint, for example, it is easily confused with an osteoarthritis flare-up or arthritis. However, making a precise diagnosis is important for starting the right treatment. Unfortunately, it still happens that people suffer from gout for years before the true cause of their pain is found.

Drinking too much alcohol can cause gout – WRONG

Drinking a lot can trigger a gout attack, but high alcohol consumption is never the cause of gout. Gout is a result of too high a level of uric acid in the blood. 90 percent of this uric acid comes from the breakdown of the body’s own cells. We only get 10 percent from our diet. Alcohol can temporarily slow the excretion of uric acid by the kidneys, which automatically increases the concentration of uric acid in the blood. This temporary increase may be the straw that breaks the camel’s back for people who already have elevated uric acid levels. Alcohol can therefore trigger a gout attack.

Gout is more common in bon vivants – GOOD

People who like to eat lavishly, often cause an additional increase in the uric acid level in their blood. Tasty food usually contains many purines, substances that are broken down in the body into uric acid. For people who already have a relatively high level of uric acid in the blood, such a temporary increase in uric acid after a large meal may be just enough to trigger a gout attack. Those who like to eat and drink well are therefore slightly more at risk of gout.

If you have gout, you should avoid acidic foods – WRONG

Some people claim that acidic or sour-tasting foods, such as yogurt and tomatoes, can make gout worse. Nothing is less true. This myth is based on the idea that the blood of gout sufferers is too acidic due to high levels of uric acid. By eating sour things, we would acidify the blood even further and that could make the gout sufferer very sour. In reality, the gout sufferer’s blood is not acidic at all. On the contrary, the uric acid is dissolved in the blood in the form of a neutral salt. Acidic food has absolutely no influence on the acidity of the blood. We have precise control mechanisms that keep the pH of the blood constant at all times. This is necessary for the normal functioning of our organism.

Gout must be treated for life – GOOD

People who experience only one gout attack in their lives are real exceptions. Once you have had a few gout attacks, you must continue your treatment with urate-lowering medication for the rest of your life. Even if you haven’t had any complaints for years. One pill a day is enough to remain free of complaints for the rest of your life. So worth it. Unfortunately, over time, many people stop their treatment or simply forget about it. The painful attacks then often return. If gout is not treated sufficiently, the kidneys can suffer damage.

You can’t solve gout with diet alone – GOOD

Because eating lavishly can trigger a gout attack in a person with an already high uric acid level in the blood, gout sufferers would do well to adjust their lifestyle. The message is to eat healthy, not to overdo it with fatty foods and, above all, to moderate your alcohol intake. A strict diet is not really necessary and will not have much effect, since diet only plays a minor role in gout. On the other hand, you should not increase high uric acid levels even further.
Products that contain a lot of purines (substances that are broken down in the body into uric acid) include almost everything that is tasty: organ meat, various types of fish, lobster, mussels, goose, lamb fillet, pork fillet, veal fillet, lentils. Many gout sufferers are overweight and have an increased risk of cardiovascular disease. Lifestyle also plays a role here. A low-fat and cholesterol diet is therefore highly recommended for every obese gout patient. It will not only benefit his appearance, but also his heart and his joints.

Gout is treated with strong painkillers – WRONG

Gout is one of the few rheumatic diseases for which we have excellent treatment. Gout patients who diligently adhere to specific anti-gout treatment almost always remain symptom-free. A gout attack must be treated with colchicine, a drug that is only used for gout attacks. Because this drug often causes diarrhea, a gout flare-up can also be treated with anti-inflammatory drugs. Once the attack is over, maintenance treatment should be started with specific medications that lower the uric acid concentration in the blood. If you follow this treatment properly, you will in principle no longer have gout attacks.

Gout never leads to joint deformities – WRONG

If gout is not treated correctly or insufficiently, the disease will over the years lead to all kinds of deformities in the joints and to the formation of typical gout lumps in the skin. These lumps mainly appear on the fingers, toes and auricles. The kidneys are also affected. With current treatment options, joint deformities should no longer occur. Unfortunately, an estimated 60 percent of gout patients are not treated as they should.

Gout is a typical male disease – GOOD

Most gout sufferers are men aged around 40. Women are only rarely affected. The male hormone may play an important role in the occurrence of gout. Children and young women are extremely rarely affected by gout.
Research shows that the uric acid level in the blood increases slightly from adulthood. In men, this increase occurs at a much younger age, which may be why they are more at risk of developing gout. In women, the increase in uric acid only occurs around menopause. If they develop gout, it is usually at an older age.

Gout is in many cases hereditary – GOOD

The uric acid in the blood comes from the breakdown of purines. Purines are breakdown products of damaged cells. Cells in the body are constantly being broken down and cleared away. 90 percent of this uric acid comes from cell breakdown and only 10 percent comes from diet. We therefore have no control over the most important part of the uric acid level. The rate of cell breakdown influences the uric acid concentration and this rate is hereditary. The fact that someone has a fairly high level of uric acid in the blood is partly determined by their genes.

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