Alcohol Abuse Advice

Gout – Causes, Symptoms, Diagnosis, Treatment

 

Gout (also called metabolic arthritis) is a disease created by a buildup of uric acid. In this condition, monosodium urate or uric acid crystals are deposited on the articular cartilage of joints, tendons and surrounding tissues due to elevated concentrations of uric acid in the blood stream. This provokes an inflammatory reaction of these tissues.

The first attack of gout subsides in a week or so without treatment. There may be a long gap of many months or years between attacks. As time passes the attacks become more frequent and more severe involving many joints. When the frequency of attacks increases progressive joint damage sets in. This is known as chronic gout. This leads to disability and crippling. Gout is very rare in women but usually affects men. In women it is seen after menopause.

Causes

Unlike other forms if arthritis, gout has a known and simple cause. It is brought on by Purines in the blood stream which break down to form a substance called uric acid. This acid collects in crystalline form around a joint causing pain and inflammation. Purines occur naturally in the body and are also found in certain foods. There is only a problem when the body produces excess uric acid, or the uric acid produced is not properly excreted. Alcohol can prevent proper elimination of uric acid through the kidneys. Plenty of water can help with elimination.

Symptoms

The small joint at the base of the big toe is the most common site of an acute gout attack. Other joints that can be affected include the ankles, knees, wrists, fingers, and elbows. Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness. Tenderness can be intense so that even a blanket touching the skin over the affected joint can be unbearable.

Tests and Diagnosis

Tests to help diagnose gout may include:

Joint fluid test. Your doctor may use a needle to draw fluid from your affected joint. When examined under the microscope, your joint fluid may reveal urate crystals.

Blood test. Your doctor may recommend a blood test to measure the uric acid level in your blood. Blood test results can be misleading, though. Some people have high uric acid levels, but never experience gout. And some people have signs and symptoms of gout, but don’t have unusual levels of uric acid in their blood.

Gout treatment:

The mainstay of gout treatment is correcting the factors that lead to the high levels of uric acid. This involves a combination of diet and drugs. Being overweight is a risk factor, so weight loss may be very important. High blood pressure (hypertension) is also a risk factor that your doctor may need to address.

Treatment of acute gouty attack requires immediate control of the acute joint symptoms followed by strategies to prevent future possible attacks, and joint and tissue damage due to the deposition of uric acid crystals in the long run. Acute attack is treated with the use of fast acting anti-inflammatory drugs. Commonly used drugs belong to the category of so-called non-steroidal anti-inflammatory drugs (NSAIDs). There are several of them like ibuprofen, diclofenac, naproxen, indomethacin . However, most of them have a major side-effect i.e. severe irritation of the gastrointestinal tract (stomach, duodenum and often small intestines as well).