Facts About Gout
What is gout ?
Gout is the result of an abnormality of the body's ability to process uric acid. Uric acid builds up either because of too much uric acid intake (from rich foods such as chocolate, seafood, red meat, alcohol) or the body's inability to process it. The uric acid then crystalizes in the joints - mainly the toes, ankles, hands and wrists - causing the painful inflammation of a gouty attack (gouty arthritis). It is more common in men than in women. It is also more common later in life with most patients having attacks after the age of 50.
Risk factors for gout include:
- Obesity, excessive weight gain, moderate to heavy alcohol intake, high blood pressure, abnormal kidney function, and some medications such as diuretics (water pills),and having low thyroid hormones may also be risk factors for getting gouty attacks.
The large joint at the base of the big toe is the most common site for a gout attack, however, any other joint can be affected. Most commonly other joints affected are the ankles, knees, wrists, fingers, and elbows.
Patients with gout attacks suffer a rapid onset of pain in the affected joint followed by swelling,
redness, and severe tenderness. Some experience pain so intense that even the light touch of a bed sheet on the joint is excruciating. These painful attacks can last from hours to several days. In cases of chronic inflammation the attack may last for weeks. Unfortunately, patients with gout are at risk for repeated attacks of gouty arthritis.
Exams and tests that may help with the
diagnosis and treatment of gout include:
1. A joint fluid analysis (arthrocentesis) to see
whether uric acid crystals are present. This is the only certain way to diagnose gout.
2. A medical history and physical exam.
3. A test to measure levels of uric acid in blood. This may be done if your doctor cannot safely get fluid from the affected joint.
4. A test to measure levels of uric acid in urine.
Staying well hydrated is the best way to prevent gout
attacks. Proper hydration also decreases the risk of kidney stones or kidney dysfunction as a result of built-up uric acid.
Avoid alcohol or only drink in extreme moderation if you have had gout attacks in the past. Alcohol affects the body's metabolism of uric acid and can cause it to build up (hyperuricemia). If levels of uric acid build up in your system it can precipitate a gout attack in your joints.
Foods rich in purines such as shellfish or organ meats (liver, kidneys, brains, sweetbreads) can lead to gout attacks. The body converts purines into uric acid, which in turn leads to gout attacks.
Overall weight reduction is also a way to avoid gout
To treat an acute attack
- Rest the affected joint(s).
- Use ice to reduce swelling.
- Take short-term medicines at the first sign of a gout attack, as prescribed by your doctor.
To manage long-term gout and prevent future attacks
- Take medicines as your doctor prescribes for pain.
- Take steps to reduce the risk of future attacks.
- Talk to your doctor about all the medicines you
take. Some medicines may raise the uric acid level.
- Manage your weight; get exercise; and limit
alcohol, meat, and seafood.