Crisis of gout: how to recognize the warning symptoms?

Crisis of gout: what are we talking about exactly?

Gout is a chronic inflammatory disease that affects about 600,000 people in France, or 0.9% of the population. It is the most common inflammatory rheumatism in men (after 40 years); in women, gout occurs later (after 65 years).

What is a gout attack? At the origin of a gout attack, there is a high level of uric acid in the blood - it is called hyperuricemia. When this level reaches (or exceeds) 60 mg per liter of blood (ie 360 ​​μmol / L), crystals form in the joints and in the soft tissues that surround the joints. This leads to an inflammatory reaction, that is to say a defense reaction on the part of the body: it is the gout crisis.

To know : if the gout attack most often affects the big toe (in 56% to 78% of cases during the first crisis), it can also be seen in the other joints of the foot (ankle), hand (wrist, fingers), elbow or knee.

Crisis of gout: causes and warning signs

Who is concerned ? People with high blood pressure, diabetes (type 1 or type 2), obesity or having suffered a cardiovascular disease (myocardial infarction, stroke ...) are more likely to have a gout attack.

What are the causes ? There is hyperuricemia (and therefore: potentially gouty attack) when the kidneys have difficulty removing uric acid - which is a "waste" in the body. This phenomenon can be related to ...

• Alcohol consumption (beer or spirits, in particular),
• A diet too rich (red meat, seafood, sweet sodas ...),
• Dehydration (after intense physical exertion, fasting ...),
• A stress situation (after a surgical procedure, for example),
• Taking certain medicines: aspirin, for example.

What are the warning signs of a gout attack?

A gout attack can be preceded ...

• From a moderate pain to a joint: it hurts when you put your foot on the ground, when folding your arm or toes, for example,
• Tingling in the joint: like "ants",
• Discomfort: it is difficult to put on a pair of shoes, for example,
• A limitation of the mobility: it is difficult to bend the wrist, to shake the fist, to walk ...

To know : It should be noted that gout is a chronic disease, which means that the patient will have seizures - which will be less than 2 years apart, more often than not.

What are the symptoms and treatments of a gout attack?

The symptoms of a gout attack are:

• A pain that occurs suddenly, often at night and / or at rest,
• Pulse pain: similar to a burning or grinding sensation,
• A pain that persists between 6 and 12 hours,
• The affected joint (often the big toe) is red, swollen, very painful and warm to the touch,
• More rarely, we can observe fever and chills.

To know : without treatment, a gout attack disappears alone in 1 to 2 weeks - thanks to the treatment, the pain disappears in just a few hours. The most common complication of the untreated gout is renal lithiasis: uric acid crystals are deposited in the kidneys and form kidney stones that can cause nephritic colic.

What treatments?

• Treatment of the gout attack is based on anti-inflammatory drugs: colchicine (low dose) and / or nonsteroidal anti-inflammatory drugs (NSAIDs).
• The basic treatment is to lower the level of uric acid in the blood below 60mg / L, thanks to a hypo-uricemic treatment to be taken for life. We must also stop beer and strong spirits, and adopt a balanced diet.

sources:

French Association for the fight against rheumatism (Aflar)

Health Insurance

University Hospital of Toulouse

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