What is Gout?

Gout is a common, recurrent condition of joint inflammation in which uric acid crystals are deposited within the joints.

This can be caused by uric acid overproduction or uric acid under excretion by the kidneys. This leads to higher uric acid levels in the blood. The condition is seen more commonly seen in men than women. Commonly, it appears in the big toe joint but may also be seen in any of the joints of the limbs.

If gout is left untreated, the joints involved may be damaged and surrounding tissues also may become inflamed. Kidney stones may also form. Five to ten percent of the population has increased blood levels of uric acid. This is called hyperuricemia, although they are not considered to have gout if they do not show signs and symptoms.

There are many factors that increase the risk for the development of gout. Diuretics like hydrochlorothiazide and furosemide can increase the risk of gout. Certain antibiotics can also cause gout. More commonly, gout appears with disorders such as leukemia, polycythemia, thyroid disease, kidney disease, high blood pressure, diabetes, high cholesterol, anemia, coronary occlusive disease, and blood vessel diseases. Other things that increase the risk of gout are family history, male gender, above the age of 50, increased weight, trauma, surgery, emotional stress, chemotherapy, and radiation treatments. Diet can also contribute to the risk of gout development and a diet high in protein and high in purines can cause an increased risk of gout.

Signs and symptoms.

* Severe and sudden joint pain that occurs within hours, especially on the big toe. Sometimes the weight of bed sheets may even be unbearable. The individual may be awakened from sleep due to the sudden intense pain.

* Red, hot and swollen joint.

* Skin overlying the swollen area may be tight and shiny.

* Painless, firm nodules on the external cartilage of the ear. These are sometimes noted on the fingers, hands, feet, Achilles tendon and under surface of forearm. This is rare and usually occurs over time. It happens in what is known as chronic tophaceous gout. The nodules are known as tophi, the plural form of tophus.

Diagnosis.

* Joint fluid analysis or arthrocentesis is the only way to specifically diagnose gout. This is to see whether uric acid crystals are present. Blood uric acid levels can sometimes be misleading and is not diagnostic of gout by itself. Other diagnostic methods are through xrays of the hands and feet and bone scan.

Treatment.

* NSAIDs or non steroidal anti inflammatory drugs like ibuprofen, naproxen, or indomethacin.

* Medication to decrease production of uric acid, such as allopurinol.

* Medication to increase excretion of uric acid by the kidneys, such as probenecid.

* Some medications such as colchicines and prednisolone.

* Warm or cold compresses on affected areas.

* Keep bedclothes off the painful joint. Design a frame that raises the sheets and blankets.

* Avoid eating anchovies, veal, bacon, liver, salmon, trout, goose, scallops and kidney. Drink at least 10 glasses of water every day to help flush out the uric acid crystals from the body and prevent stone formation.

* Avoid alcohol since it can increase uric acid levels and bring about an episode of gout.

* Lose excess weight but do it slowly and under the supervision of a physician. Crash diets with rapid weight loss can provoke an attack.

* Rest the affected joint in case of a severe attack and for 24 hours after the attack.

* Discuss the side effects of all other medications you are taking. Understand the side effects of the medications you do take for gout.

Natural supplements like GouTrol from DrLamLabs.com have been especially helpful to soothe symptoms in patients with gout.