subject: What is gout and how can it be prevented or treated? [print this page] What is gout? What is gout?
In the infinite pages of history books, gout is known as "the disease of kings" or "rich man's disease". It is a medical condition that is related to arthritis and most of the time affect the metatarsal-phalangeal joint at the base of the big toe . It could also present as kidney stones , urate nephropathy or tophi. It is caused when high levels of uric acid in the blood become crystallize and then deposited in joints, tendons, and surrounding tissues. It affects around 12% of the Western population at some point during their lives but it became more frequent in recent years. This is believed to be related to the risk factors in the population such as longer life expectancy, metabolic syndrome and changes in nutrition.
A clinical visualization of the characteristic crystals in joint fluid is by far the best diagnosis . The symptoms can be improved with steroids, colchicine or non-steroidal anti-inflammatory drugs (NSAIDs). After the acute attack has settle down, levels of uric acid can be diminished through daily habits. Allopurinol or probenicid is known to provide long lasting relief for people with frequent attacks.
What are the signs and symptoms to look for?
Gout can make it's presence in many ways but the most common form is an acute inflammatory arthritis (a red, tender, hot, swollen joint). Other joints like the heels, knees, wrists and fingers may also be affected. Joint pain causes fatigue, high fever and usually starts during the night (over 24 hours) and lower body temperature disturbs the sleeping process.
Hyperuricemia is a long-standing elevated uric acid levels that may result in other symptomatology like tophi (non-painful deposits of uric acid crystal) and long term effects may lead to chronic arthritis because of bone erosion. Those crystals can precipite in the kidneys resulting in stone formation (urate nephropathy).
What causes it?
Hyperuricemia is the main cause of gout and can occur because of diet changes, genetic or underexcretion of urate, the salts of uric acid. Renal underexcreation of uric acid is mostly what causes hyperuricaemia 90% of the times and overproduction is the cause in less than 10%. About 10% of people affected with hyperuricemia will develop gout at some stage during their life. However the risk varies depending on the degree of hyperuricemia.
A level between 415 and 530 mol/L (7 and 8.9 mg/dL) the risk is 0.5% per year.
A level greater than 535 mol/L (9 mg/dL) increases the risk to 4.5% per year.
Other causes are food consumption (alcohol, fructose sweetened drinks, meat and seafood), genetic (contributing to about 60% of variability in uric acid level) and other combination with other medical problems.
How to prevent it and treat it?
Lifestyle choices that are proven to be very effective are avoiding obesity , reducing intake of food high in purines like meat and seafood, consuming adequate vitamin C, very low alcohol and fructose consumption.
Treatment is initially aim to settle the symptoms of an acute attack. Different drugs like nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, steroids are used to reduce the serum uric acid levels and applying ice for 20 to 30 minutes several times a day may decrease the pain.
What is gout and how can it be prevented or treated?
