Gout is one of the oldest known rheumatic diseases. Gout arthritis is an inflammatory rheumatic disease as well as a metabolic disease. It can progress with diabetes, hypertension, goiter, atherosclerosis and heart diseases. Therefore, patients with gout have an increased risk of heart attack and stroke. It is more common in men and postmenopausal women.
As the enzymes involved in protein metabolism cannot perform their functions adequately, the proteins that we take from the outside through food are broken down into urea, and the removal from the body slows down, and most of the taken proteins remain at the level of uric acid. Our body also has a protein cycle. During the programmed cell death stage (apoptosis) during cell regeneration, all of our cells are broken down and the proteins that are released are also included in protein metabolism. For this reason, in carcinogenic events where cell death is accelerated, etc. In this case, the protein load of the body increases and if there is no complete destruction, uric acid accumulation is observed. Again, in cases where the kidneys do not work adequately (renal failure) or in the case of using substances that slow down the excretion of uric acid from the kidneys, such as alcohol, uric acid accumulation occurs in the body. Uric acid is a large molecule and cannot stay in the circulation for a long time, and when it reaches the thin vessels (capillaries), it passes into the tissue. The presence of uric acid, which should not be in the tissues, stimulates our immune system and inflammation begins. This is followed by gouty arthritis or tofus deposits. It can cause kidney stones in the future.
Gout is a disease that progresses with attacks. There is a genetic predisposition. When a heavy meat meal is eaten or a large amount of alcohol is consumed, the disease is triggered and an attack occurs. Some blood pressure medications, aspirin, diuretics and chemotherapy drugs can also cause uric acid accumulation and attacks.
Joint involvement is extremely painful and has a sudden onset. It most commonly affects the big toe joints, which is called podogra. This finding is diagnostic. It can cause inflammation in all joints in the body. The table starts abruptly. It is so painful that it is not possible to wear shoes and keep the foot in the quilt at night.
The priority in the treatment is to relieve the patient’s symptoms and relieve him. Simultaneously, anti-inflammatory drugs are started to prevent inflammation. The person’s diet and medications are regulated. If it is not possible to keep the uric acid level in the body within normal limits with diet to prevent the occurrence of new attacks, drugs that increase uric acid excretion from the kidneys and reduce its reabsorption are used. It is necessary to keep other diseases such as concomitant diabetes, high blood pressure, arteriosclerosis and thyroid gland diseases under control.