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.
- 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.
French Association for the fight against rheumatism (Aflar)
University Hospital of Toulouse
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