Gout

20th October 2006 at 21:28 BST by Dr.C.A.Jenner MB BS, FRCA. Permalink.

Gout

Introduction

Gout is a form of arthritis and a systemic disease caused by the accumulation of uric acid crystals in joints.

Incidence and Prevalence

Nearly one million people in the United Sates suffer from attacks of gout. In fact, gout has the distinction of being one of the most frequently recorded medical illnesses throughout history.

Gout is nine times more common in men than in women and predominantly attacks males after puberty. However, the incidence of gout increases in women in the post-menopausal stage.

The condition has been found to be quite rare in children and young adults.

Stages of Gout

There are four distinct stages of gout. Here we briefly explain each one of them:

1) Asymptomatic: The level of plasma uric acid increases, but there are no specific symptoms.

2) Acute: The first attack of gout marks the onset of this stage. While the mild attacks usually go away quickly, the severe ones can even last for weeks.

3) Intercritical: This is a symptom-free interval that may last for months or years.

4) Chronic: In this stage, the gout attacks become very frequent and affect multiple joints at one time.

Signs and Symptoms

Gout normally develops in the joint of the first toe, known as the big toe or hallux. Symptoms of gout generally develop quickly and mostly develop in one joint at a time. Here we list some of the most common signs and symptoms of gout:

• Inflammation

• Pain and redness

• Stiffness and swelling

• Red or purple skin around the joint

If the symptoms of gout aggravate, even touching or moving the toe can be intensely painful.

Causative Factors

Gout is caused by the buildup of uric acid in the joints. An increased blood level of uric acid occurs when the liver produces more uric acid than the body can excrete in the urine. Known as hyperuricemia, this condition can also occur on the consumption of a diet high in rich foods, such as red meat, cream sauces and red wine.

Other main causes of gout include

• Excess consumption of alcohol

• Genetics

• Obesity

• Exposure to lead

• Surgery

• Joint injury

• Crash diets

• Chemotherapy

• Crystal deposits (normally resulting in pseudogout)

• Medications that might interfere with the body’s ability to remove uric acid.

Diagnosis and Treatment

To diagnose the condition of gout, a needle is inserted into the affected joint and a sample of the fluid that lubricates the joint (synovial fluid) is drawn. This fluid is then examined for the presence of uric acid crystals.

Treatment Options

The goal of treatment of gout is to decrease the amount of uric acid in the joints, which further helps to reduce symptoms and prevent further attacks. Following are generally prescribed for this purpose:

• Diuretics

• Anti-inflammatory medications, including NSAIDs, Corticosteroids, Colchicine

• Cyclosporine

• Levodopa

• Niacin

Prevention

Prevention is regarded as the best defense against gout. Main preventive measures include:

• Take mild medication

• Drink plenty of fluids

• Exercise regularly

• Maintain a healthy diet and body weight

• See a physician regularly