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Gout

Gout is a condition of elevated uric acid associated with a build-up of uric acid within the joints and inflammation of the joints. There is acute gout, which is a painful condition of one joint that occurs on a single occasion. Chronic gout involves repeated joints of inflammation and pain of the affected joints, which usually involves more than one joint.

Causes of gout include a higher than normal level of uric acid in the body. The body may make too much uric acid or can have problems getting rid of uric acid. If there is too much uric acid in the body, the joint collects uric acid crystals, which inflame the joint. The crystals irritate the joint and cause the joint to become swollen and inflamed.

You can have high levels of uric acid without having gout, a condition called hyperuricemia. The exact cause of gout and hyperuricemia are unknown. Gout tends to be somewhat hereditary and is more common in men. Postmenopausal women, those who drink alcohol and those who take certain medications (diuretics like hydrochlorothiazide) are at greater risk of gout or hyperuricemia.

Others who get gout are those who have kidney disease, diabetes, sickle cell anaemia, other haemolytic anaemias, obesity and leukaemia. The condition can also happen when you take medications to remove uric acid from the body but tends to be a problem that is only in the first few days or weeks of taking the medication.

Symptoms of acute gout attacks include the sudden onset of symptoms in one or more joints. The common places for gout attacks include the large toe, the knee and the ankle joints. The pain starts often during the nighttime hours and awakens the person with a throbbing, excruciating and crushing pain in the joint. The joint looks warm and is often red. It is usually extremely tender to the touch so that even a cloth placed upon the joint reproduces the pain. The attack lasts for several days but often returns to the same joint over and over again. Subsequent attacks last longer than the initial attack. Between attacks, you can have no symptoms. The distance between attacks can be many months or even years.

Chronic gouty arthritis can develop in certain individuals. There can be a deformity of the joints and a loss of movement in the affected joints. The symptoms are chronic and not episodic. The individual can develop gouty tophi, which are lumps beneath the skin around the joints of the hands and feet in particular. Tophi can drain out a chalky material. Tophi can develop after you have had the disease for many years. After one gouty attack, another attack can happen in more than half of the people.

Tests can be done to see if there is gout. A synovial fluid analysis can show the presence of uric acid crystals in the synovial fluid. A blood level of uric acid can show elevations in uric acid. X-rays of the joint can be performed which may show abnormalities or may be normal. A biopsy of the synovial tissue can show uric acid crystals in the joint tissue. A urine uric acid level can be done to show elevations in urinary excretion of uric acid.

Treatment of gout is two-fold. There is the aspect of treatment that results in decreased inflammation in the joint. There is also the aspect of treatment related to lowering the uric acid level. If you have a sudden attack of gout, you need to take nonsteroidal anti-inflammatory medications in order to block the inflammation of the joint. You can also take opioid drugs, such as codeine or hydrocodone. Colchicine can be used to reduce the inflammation and pain of gouty arthritis. Corticosteroids are also helpful in reducing inflammation.

Daily use of the medication allopurinol can decrease the level of uric acid in your blood. It is used whenever you have repeated episodes of gouty arthritis during a given year, you have gouty arthritis currently or you have uric acid stones in your kidney.

You can use diet and lifestyle changes in order to help stop gouty arthritis attacks. Avoid drinking alcohol or eating organ meats, legumes, mushrooms, gravy, spinach, asparagus, baking yeast and cauliflower. You should also limit your meat intake and avoid fatty foods. You should eat plenty of healthy carbs and lose weight on a slow and gradual basis.