Podagra or gout (also called as the “disease of the rich” or the “king’s disease) is a disease that occurs due to the elevated levels of uric acid in the blood marked by recurrent attacks of chronic arthritis characterized by red, tender, swollen joints. The most commonly affected is the metatarsal-phalangeal joint at the base of the big toe. Apart from the toe joint, knees, heels, fingers and wrists are other commonly affected areas among patients. The disease may also occur in the form of tophi (hard, painless deposits of uric acid crystals), kidney stones, or urate nephropathy.
Causes of Podagra
Podagra is the disorder of purine metabolism and as mentioned above, it occurs due to increased levels of uric acid (hyperuricemia) in the blood which later crystallize (in the form of monosodium urate) and settle down in the various precipitating joints, tendons and tissues of the body causing redness and swelling. Hyperuricemia can occur due to a number of reasons including genetic predisposition, over production of uric acid, under excretion of uricase (which breaks down uric acid prevalent in most of the cases), or due to an unsuitable diet.
Lifestyle: Consumption of fructose-sweetened drinks, alcohol, meat and seafood; surgery and physical trauma trigger conditions of hyperuricemia. On the contrary, consumption of purine-rich vegetables, protein, dairy products, vitamin C and coffee are said to decrease any such risk.
Genetics: One cause of hyepruricemia can be the genes, contributing to about 60% of variability in the level of uric acid.
Medical conditions: Certain pre-medical conditions also trigger Podagra. Some Podagra complimenting diseases include metabolic syndrome (a combination of abdominal obesity, insulin resistance, hypertension and abnormal lipid levels), lead poisoning, polycythemia, hemolytic anemia, renal failure, psoriasis, solid organ transplants and the Lesch-Nyhan syndrome.
Medications: Diuretics have often been associated with Podagra including other medications such as niacin and aspirin (acetylsalicylic acid), cyclosporine and hydrochlorothiazide as well as certain immuno-suppressive drugs such as ciclosporin and tacrolimus.
Symptoms of Podagra
While the symptoms may vary across patients depending upon the seriousness of the disease, the level of hyperuricemia and other causal factors, some common symptoms experienced by patients worldwide include:
Joint pain: Patients experience pain in the Podagra affected joints ranging from 2-4 hours, especially during night hours (as the temperature of the body drops down allowing the crystallized uric acid to harden further). Pain can be generally reduced by application of ice on the joint several times a day. It also eases redness and swelling.
Inflammation or swelling over the joint: Inflammation also accompanies during acute cases of Podagra giving rise to pain in the joints.
Redness: A chronic attack of Podagra is often accompanied by redness in the affected joint.
Inability to move
Fluid discharge from the Podagra affected site/ joint
Some common treatments practiced for the treatment of Podagra include application of ice (for 20 to 30 minutes several times a day) and consumption of non-steroidal anti-inflammatory drugs (NSAIDs) like colchicine and steroids, allopurinol, probenecid and febuxostat and pegloticase.
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