Faits Rapides sur la Goutte

Historically, gout was referred as “the king of diseases and the disease of kings” or “rich man’s disease” and its’ first documentation goes back all the way to 2600 BC Egypt. Why? It’s obvious that royalty and the rich could afford meats, alcohol and liked to fatten themselves up with other rich foods, as for the lower class they were stuck with a carbohydrate diet, whatever fruits and vegetables they raised on their land, rarely eating any meat but living a healthier life! Several hundred years ago gout was also thought to be caused by drops of viscous humors that seeped from blood into the joints. The word Gout is derived from Latin word gutta meaning “a drop of liquid” and  has the unique distinction of being one of the most frequently recorded medical illnesses throughout history.

Qu'est-ce qui cause exactement la goutte ?

Ce qui cause la goutte, c'est l'excès d'acide urique in the body and is one of the most painful form of arthritis. It’s a complex disorder that is more prevalent among men, and afflicts women more commonly after menopause. Besides men have higher uric acid levels in their blood than women, that’s why nearly 6% of men have it and 2% of women in the US. That’s about 8 million Americans that have gout! Gout is a kind of arthritis caused by a buildup of uric acid crystals in the joints.

Uric acid has no useful function in the human body; it is simply a breakdown product of purines, a group of chemicals present in all body tissues and many foods. Uric acid is a breakdown product of purines that are part of many foods we eat mostly found in meats, seafood etc… An abnormality in handling uric acid and crystallization of these compounds in joints can cause attacks of painful arthritis, kidney stones, and blockage of the kidney filtering tubules with uric acid crystals and may lead to eventual kidney failure.

Most of the time uric acid dissolves and goes into the urine via the kidneys. However, if the body is producing too much uric acid, or if the kidneys are not excreting enough uric acid, it builds up.  The accumulation may result in sharp urate crystals which look like needles.(1) They accumulate in the joints or surrounding tissue and may cause pain, inflammation and swelling.

It’s usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint (God knows I’ve had many) and the most commonly affected area is the big toe 50% of the time and is called podagra.. Other joints that can be affected include the ankles, knees, wrists, fingers, heels and elbows and it is wise to always rest the joint that hurts as much as possible. In some people, the acute pain is so intense that even a bed sheet on the toe causes severe pain.

Personnellement, j'ai passé des nuits blanches à me retourner et essayer de soulager la douleur avec un sac de glace. En général, les crises de goutte surviennent au milieu de la nuit, supposément parce que la fraîcheur et la baisse de température facilitent la cristallisation de l'acide urique dans l'articulation.

Digging deeper, high levels of uric acid in the blood called L'hyperuricémie is the underlying cause of gout. Surprisingly, hyperuricemia is commonly found in many people who never develop gout. Scientists are not completely sure what causes hyperuricemia. There is definitely a genetic factor because a person who has close relatives with hyperuricemia is more likely to develop it himself.

Pour confirmer un diagnostic de goutte, votre médecin peut prélever un échantillon de liquide provenant d'une articulation enflammée pour rechercher des cristaux associés à la goutte ou faire un test sanguin pour mesurer la quantité d'acide urique dans le sang.

Qui est à risque ?

En fin de compte, vous êtes plus susceptible de souffrir de la goutte si vous êtes un homme, obèse, si cela se trouve dans vos gènes familiaux, si vous buvez de l'alcool en excès, si vous mangez des aliments riches en purines, si vous prenez régulièrement de l'aspirine, de la niacine ou des diurétiques, si vous avez de l'hypertension, une intoxication au plomb, une chirurgie, etc. Des complications peuvent également survenir, telles que des crises de goutte récurrentes, une goutte avancée dans laquelle des cristaux d'urate peuvent se former sous la peau en nodules appelés tophi, des calculs rénaux pouvant causer l'accumulation de cristaux d'urate dans les voies urinaires, la goutte pouvant également se propager à d'autres articulations et causer évidemment des dommages aux articulations.

Mythes sur la goutte

Despite gout being an increasingly common disease, there are still a lot of myths about it that people believe. Let’s take a look at what they are and debunk each one.

Mythe 1 : Seules les personnes riches et obèses ont la goutte

At one time this was true, but these days, hardly. The regular person now has access to all sorts of food and with processed food becoming more common, it’s not hard to be at risk for developing gout. Your yearly income has nothing to do with gout but your genes certainly does. If one of your parents had gout, you’re likely to develop it later on if you’re not careful.

Mythe 2 : La goutte n'attaque que le gros orteil

It is very common for the first gout attack to happen in the big toe. But uric acid doesn’t just accumulate crystal deposits here. It can affect other joints too like your elbows, hands, knees, and ankles. 

Mythe 3 : Seuls les hommes peuvent avoir la goutte

Les femmes peuvent également avoir la goutte, mais elles sont moins exposées que les hommes. Cela est dû au fait que les femmes ont de l'oestrogène qui aide à éliminer l'acide urique dans le corps. Une fois qu'elles atteignent la ménopause, elles sont plus susceptibles de développer la goutte.

Mythe 4 : Si vous suivez un régime alimentaire sain et évitez les déclencheurs de la goutte, vous pouvez éviter les crises de goutte.

While maintaining a healthy diet and avoiding high purine foods is important for managing your gout symptoms, this alone will not make your condition go away. Unfortunately, gout is an irreversible condition; once you have it, you have it forever. The good news is that there are now numerous medications you can take to manage your condition. There’s medicines specifically for lowering uric acid and then there’s also some for getting rid of the pain and swelling. If you have conditions like kidney disease along with your gout, there’s medicine for that too.

Mythe 5 : La goutte est une condition auto-infligée.

 This is often one of the biggest myths that gout patients has had to debunk for people they know.  It’s very common to joke about gout because it was once known as a rich man’s disease. Sure, lifestyle can be a contributing factor to developing gout, but as we mentioned earlier, it is also genetic. So it doesn’t matter how good you are with dieting and exercising, if your family history has it, you’re more likely to have it too.

Myth 6: Gout is an old man’s disease

Men are more likely to get gout earlier in life. This is due to a combination of factors: genes and our modern lifestyle. If you live a high stress life and eat an unhealthy diet, you’re more likely to inherit gout from one of your parents. 

What has your experience been like with gout? When were you diagnosed with it and how did you deal with it? Share your thoughts in the comments below. 

Crédits

1. www.medicalnewstoday.com