If your friend or a family member has been recently diagnosed with gout and you are wondering how you can help them or take care of them, keep reading. The article talks about tips to help someone with gout.

What is Gout disease, and what does it look like?

Gout is a medical condition, which occurs due to high blood uric acid levels in the body. The accumulation of uric acid in the body causes swollen, red, hot, and stiff joints. 

What is Uric acid and how is it related to Gout disease?

Uric acid is a waste product formed from the breakdown of purines. Purines are stored in body tissues and are available in food such as dried beans, anchovies, peas, and liver. In normal individuals, uric acids dissolve in blood, and it passes through the kidneys and is excreted out of the body via urine. 

Uric acid crystals and Gout

However, in some cases, uric acids accumulate and form needle-like crystals, and they may form in joints, which becomes a harrowing experience. The crystals may also lead to kidney stones formation. Gout can also attack ankles, wrists, fingers, elbows, and knees. Gout attacks over a period last longer and happen more often. 

In gout, a person will experience swelling and pain in joints (especially the foot). Sudden intense pain or gout attacks can make a person feel like their foot is on fire. 

Gout Symptoms

Most people with high blood uric acid levels may not have any symptoms. On the other hand, signs and symptoms occur suddenly and often at night. The symptoms can include: 

• Inflammation of joint or joints 
• Redness of joint or joints 
• Limited range of motion 
• Intense joint pain 
• Lingering joint pain 

Between the gout attacks, the person may not experience any symptoms. While if gout is left untreated, it can become chronic. The uric acid crystals may become hard lumps and develop in the joints, skin, and soft tissue surrounding the joints. These lumps may cause permanent damage to the joints. 

Causes of Gout

Certain conditions may cause increased uric acid production or reduce uric acid excretion, such as dehydration, blood, and metabolic disorders, kidney disorders, thyroid problems, or genetic conditions. 

Gout Risk Factors

Following are some of the risk factors that may make a person vulnerable to gout: 

• Consumption of alcohol 
• Family history of gout 
• Middle-aged man 
• Postmenopausal woman 
• High blood pressure 
• Kidney disease 
• Thyroid disease
• Diabetes 
• Sleep apnea 
• Consume food that is rich in purines 
• Medications (diuretics and cyclosporine)
• Overweight 
• Recent surgery or trauma

Gout Diagnosis, how to diagnose?

Physicians will examine the symptoms and inspect the affected joint areas to diagnose gout. Following a physical examination and taking the history, the doctor may recommend the following test (one or combination) to confirm the diagnosis: 

• Blood test: Your physician may request a blood test to determine blood uric acid levels. However, a blood test does not confirm the diagnosis. Since many people with high uric acid levels do not have gout. And, on the contrary, some people with signs and symptoms of gout do not have high uric acid levels
• Joint fluid examination: The doctor may collect fluid from the affected area (joint) to examine the uric acid crystals that are visible under the microscope to confirm the diagnosis of gout 
• Ultrasound (sonography): USG uses sound waves for the determination of tophi or urate crystals in the joints 
• X-rays: X-rays of the affected joint can help to rule out other causes of joint inflammation 
• Dual-energy computerized tomography (DECT): The DECT test uses a combination of X-ray images taken from different angles to examine the presence of urate crystals in the affected joint

Gout Treatment and Medications 

The treatment aims to reduce pain and inflammation or the frequency of gout attacks. Some traditional treatments include making dietary changes and taking medications. 

Diet modification for Gout

Diet alteration is a vital way to reduce the number of gout attacks. Diet modification aims to lower blood uric acid levels. The following changes may help to reduce gout symptoms: 

• Consume a lot of water or non-alcoholic beverages 
• Consume low fat or nonfat dairy products
• Decrease or stop alcohol consumption
• Avoid consumption of high purine foods 
• Consume complex carbohydrates (fruits, vegetables, whole-grain bread)
• Reduce meat consumption 
• Switching to plant-based protein (beans and legumes)

Gout Medications

Several medications of different classes are used in the treatment of gout. The motto of the treatment is to reduce pain and inflammation, decrease uric acid production, or increase uric acid excretion. 

• Medication that decreases pain and inflammation: Non-steroidal anti-inflammatory drugs (NSAIDs), Colchicine, and Corticosteroids are some of the examples that reduce the number of gout attacks, thus reducing the pain and inflammation caused by it
• Medications that increase uric acid excretion: Probenecid is a drug that improves kidneys’ function to remove uric acid from the blood 
• Medications that reduce uric acid production: Xanthine oxidase inhibitors (Allopurinol) reduce the amount of uric acid production, thus helping to reduce the number of gout attacks

How can you help someone suffering from Gout?

It is vital to support your loved ones who are suffering from gout. 

• Firstly, start encouraging them to embrace a healthy lifestyle. You can also join them and assist them with walks. You can help them in daily activities (cooking, cleaning).
• If you live under the same roof, switch to healthy food items (items containing fewer purines). Encouraging the person to quit bad eating and drinking habits (limit or stop alcohol consumption, drinks with high sugar content), as adopting a healthy lifestyle is key to gout and other diseases. 
• It would be best to motivate them for regular exercise and reduce weight to reduce the risk of gout.
• Help the person switch to low-fat dairy products (a good protein source), advised for people suffering from gout. 
• Try to reduce red meat consumption and encourage them to consume more complex carbohydrates foods (fruits, vegetables, whole-grain bread). Switching to plant-based proteins helps a lot. 

Gout Side effects 

Side effects of the medications are different for each class of the drugs. Below mentioned are side effects of the medications that are categorized by their classes: 

1. Xanthine oxidase inhibitors class of drugs does have some side effects. It is possible that some of them may not experience any side effects or may experience minor side effects. Inform the doctor if any of the below mentioned side effects are severe or do not go away:

• Diarrhea 
• Drowsiness 
• Stomach upset 

Some of the side effects can be serious and may require medical attention. Call your doctor immediately if they experience them: 

• Itching 
• Weight loss
• Loss of appetite 
• Painful urination 
• Skin rash 
• Swelling of lips or mouth 
• Fever 
• Sore throat 
• Chills 
• Blood in urine 
• Irritation of the eyes 

2. Non-steroidal anti-inflammatory classes of drugs also have some side effects. It is possible that they may not experience any side effects or may experience minor side effects. Inform your doctor if any of the below mentioned side effects are severe or do not go away:

• Stomach aches 
• Headaches 
• Dizziness 
• Allergic reactions 
• Stomach ulcers 
• Indigestion 
• Diarrhea 

3. Medications like Probenecid and Colchicine may cause some side effects. Some of the common side effects of Probenecid and Colchicine are: 

• Nausea 
• Hair loss 
• Headache 
• Flushing (warmth, tingly sensation, or redness)
• Dizziness 
• Stomach pain 
• Loss of appetite 

Stop using the medications if they experience any of the below-mentioned side effects and call your doctor immediately: 

• Fever 
• Seizure 
• Unusual bleeding 
• Weakness 
• Severe diarrhea 
• Stomach pain 
• Pain in the lower back 
• Blood in urine 
• Muscle weakness 
• Mood changes 
• Vomiting 

The above-mentioned side effects of each class of medication are not comprehensive. There may likely be other side effects. Call your physician if they experience anything unusual or persistent. 

Other Gout precautions 

Please inform the doctor and pharmacist about allergies to any medication or any of its ingredients. If they have any other allergies, do not forget to share the same with the healthcare professional. 

Inform your health worker about other prescription, non-prescription medications, and nutritional supplements that are being taken. Also, inform about vitamins and herbal supplements consumed or planned. 

What to do if you have Gout and become pregnant

Inform your doctor if they are suffering from any comorbidities. You should inform your physician if they are pregnant, planning to get pregnant, or breastfeeding. If they become pregnant while on treatment with any medication, inform your doctor immediately. 

Some of the medication prescribed may make them feel drowsy. You make sure that the person on medications should not drive or operate machinery until they know how this medication affects them. 

Gout and alcohol

You should make sure they do not consume alcoholic beverages while taking some of the medications, as alcohol reduces the effectiveness or may worsen the side effects of medication. 

Please encourage them to drink at least eight glasses of water or other fluids each day while on treatment with some of the medication, unless directed to do otherwise by your physician. 

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