Gout is a type of acute arthritis that causes severe pain and swelling in the joints due to increased uric acid levels in blood resulting in deposition of uric acid crystals in the joints.
If there is high concentration of uric acid in the blood (either due to excess production or poor excretion) urea crystals gets formed. When these urate crystals deposit around the joint they cause symptoms of gout.
Incidence of gout is more in men vis-a-vis women primarily because women tend to have lower uric acid levels than men do.
Risk factors for gout include lifestyle factors like excessive alcohol consumption.
Certain medical conditions like untreated/uncontrolled hypertension, diabetes, hyperlipidemia (high fat and cholesterol levels) and arteriosclerosis (narrowing of the arteries) also serves as risk factors.
Medications like certain diuretics (thiazide), anti organ rejection drugs (prescribed for people who have undergone an organ transplant) are also the risk factors for gout.
Menopause in women and a positive family history also serves as risk factors for Gout.
There is a sudden inflammation, reddening, warmth and tenderness accompanied by intense burning pain of the joints.
Generally it is associated with the big toe of the feet but its can
affect ankle, feet, heal, instep, knees, hands, wrists, elbows, fingers
and spine. It subsides in five to ten days without treatment. The pain
subsides in one to two weeks. However, even after the severe pain and
inflammation subsides some degree of joint discomfort may continue to
be there for few weeks more. Subsequent attacks are likely to last
longer and affect more joints.
Diagnosis of gout can be done based on microscopic examination of the fluid of the affected joint for presence of uric acid crystals and blood tests for uric acid levels. Blood tests may have confusing results. Some people may have high uric acid levels in blood but no symptoms of gout. And people with gout may not have elevated uric acid levels in blood.
Other tests are done to rule out other causes of arthritis. The tests are full blood test, electrolyte levels, erythrocyte sedimentation test, thyroid function test and renal functional test.
Treatment is given to treat symptoms, prevent future attacks and to reduce serum uric acid levels.
Medications given in gout are non-steroidal anti inflammatory drugs (NSAIDs), Colchicines and Corticosteroids. Steroids may be given orally or in the injection form.
Recurrent symptoms of gout, urinary bladder stones and kidney stones are the complications of gout.
Untreated gout may cause uric acid crystals deposits under skin causing nodules called as Tophi (TOE-fi). Generally they are not painful but during gout attack they may become tender and painful.
To prevent future gout attack medications to block the production of uric acid or to facilitate the removal of uric acid are given.
Dietary changes to avoid gout are prescribed like less red meat and sea food, more low fat dairy products, more whole grains (complex carbohydrates) and avoiding alcohol. Maintaining healthy weight but avoiding rapid weight loss and fasting is important.
