If you suffer from gout, you are most likely concerned about preventing and managing gout complications, since the joint pain and swelling are so intense during these episodes. You should also be aware of the possible progression of this condition. Let’s review how gout can progress over time and what you can do to stay as healthy as possible.
The most painful episode, called acute gouty arthritis is characterized by inflammation and pain of a single joint (usually the toe or knee). Over the years these flare ups may extend and affect multiple joints at once, and sometimes you may experience fever.
A second phase of the gout is so called intercritical period, when you have very little or no symptoms at all. The second flare up occurs usually within the next two years, followed by more acute attacks over the years. If you don’t treat promptly the symptoms, the following flare –ups may become more frequent, more intense and last longer.
The third phase of the gout is called chronic tophaceus gout and develops naturally as the gout progresses. It happens because larger quantities of the urate crystals accumulate in the joints, bursae (those fluid filled sacs that protect the joint), bones, and cartilages and under the skin. These deposits of urate crystals are called to phi. Tophi are usually painless, however they can become infected, cause joint damage and trigger a flare up. Individuals who take the drug cyclosporine, those who don’t take optimal dosage of anti-gout medication and postmenopausal women are at increased risk to develop chronic tophaceus gout.
Complications with Gout
Beside the three phases described above, gout can also progress over time and affect the joints in other ways (i.e. infections, or degenerative arthritis) and other organs. For example, the urate crystals can accumulate in the kidneys, leading to kidney stones and impaired kidney function. There is in increased risk to develop other infections in the body or impairments of the spinal cord and nervous system.
Recent studies also found an increased risk of cardiovascular diseases, including heart attacks and stroke. Is not well understood whether the gout directly affects the heart, or indirectly - because gout sufferers are also more likely to have insulin resistance, diabetes and high cholesterol.
Tips to stay healthy
- The risk of flare-ups can be significantly reduced if you follow the treatment for gout, maintain a healthy diet (low in purines), and avoid alcohol, overeating and fasting.
- Ask your doctor to evaluate periodically your heart, kidneys and your joints. If you have high blood pressure and high cholesterol, make sure these conditions are well controlled.
- Stay active and exercise daily; adopting a fitness plan will help you keep your joints mobile, protect the heart and boost your immune system.
- If you developed tophi, you can choose to have them removed. Some people remove them for aesthetic reasons, while others want to prevent complications.
- Stay away from stress. Stress can trigger flare ups, aggravate heart conditions and make you more likely to develop infections. Yoga, deep breathing or meditation is good choices to reduce your stress levels.