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GOUTNil


Gout is a kind of complex form of arthritis that can affect anyone. It is caused by the build up of uric acid crystals in the joint. It is characterized by sudden severe joint pain, usually affecting the big toe, wrists, elbows or knees.


Symptoms


The symptoms of gout occur suddenly, often at night with intense pain, inflammation and redness in the affected area. The pain will be severe for the first 4 to 12 hours and subsides thereafter with some persisting joint discomfort. Later it affects more joints and the pain becomes more severe and lasts longer. Other symptoms and signs of gout include:

  • Swollen joints
  • Lingering discomfort
  • Limited range of motion
  • Deposits of uric acid crystals under the skin which is called tophi
  • Redness and warmth in joints

Causes

Gout is caused by the deposition of uric acid crystals in the joint. Uric acid is a breakdown product of purines, which is present in many foods we eat. Excess production of uric acid and an abnormality in handling uric acid causes its crystallization in the joints which causes arthritis and these crystals may block the kidney filtering tubules which results in kidney stones or kidney failure.


Risk Factors


Risk factors that increase the level of uric acid in your body include:
Age and sex: Men are more likely to develop gout because women have lower uric acid levels. However, after menopause women’s uric acid level approaches those of men. So gout occurs earlier in men whereas women develop symptoms after menopause.
Obesity: If you are obese the body produces more uric acid and the kidneys will have difficulty in eliminating this uric acid.
Diet: Eating more seafood and meat, consumption of alcohol and drinking beverages with fructose increases the level of uric acid in blood and also increases the risk of gout.
Medical Conditions: Certain medical conditions and diseases such as diabetes, high blood pressure, heart and kidney diseases increase the risk of gout.
Medications: Certain medications like aspirin and thiazide diuretics increase uric acid levels in blood.
A family history of gout
Recent surgery or trauma also increases the risk of developing gout.


Diagnosis and Treatment


A patient is considered for diagnostic tests, when he/she reports repeated attacks of painful arthritis at ankles, knees or at the base of the toes. Initial evaluation is for blood uric acid levels. Secondly, fluid from the joint is obtained by joint aspiration and examined under a microscope to determine if uric acid crystals are present.
When gout is mild and uncomplicated it can be treated with diet and lifestyle changes. When there is frequent pain, evidence of joint damage from gout and tophi are present, medications will be necessary to lower uric acid levels and to provide relief from gout pain.

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