Gout - Causes, Symptoms and Treatment

Gout is a disease due to an inborn uric acid metabolism. Gout is condition that results from crystals of uric acid depositing in tissues of the body. Excessive loss of body water (dehydration) as a result of a hard game of tennis or other vigorous activity may contribute.

Gout is characterized by an overload of uric acid in the body and recurring attacks of joint inflammation ( arthritis ). Gout has the unique distinction of being one of the most frequently recorded medical illnesses throughout history. A gout attack may be triggered by minor injury (such as from ill fitting shoes), food or alcohol overindulgence,fatigue, infection, treatment with some drugs (penicillin, insulin, diuretics or "water pills"). Without treatment, a first attack of gout may last several agonizing days.

Gout is usually an extremely painful attack with a rapid onset of joint inflammation.Gout is a complex disorder that can affect anyone. Chronic gout can lead to deposits of hard lumps of uric acid in and around the joints, decreased kidney function, and kidney stones. It is often related to an inherited abnormality in the body's ability to process uric acid. If you suspect you are having a gout attack, get in touch with your physician as quickly as possible. He can prescribe an anti-inflammatory drug.

Although drugs provide relief, there may, in some cases, as with all medications, be side effects. It is usually said that once on a drug for gout, attacks will recur when the drug is stopped. A personal experience, shared by some other physicians, albeit not a scientific evaluation, warrants noting. By keeping up an adequate intake of fluids and increasing fluid intake at the first sign of joint discomfort, I have been able to forestall symptoms, eliminating the need for drugs.

Causes of Gout

Some causes of Gout:

• Gout is caused by the buildup of uric acid in the joints.
• Uric acid is a chemical which is a natural part of the normal breaking down and building up of food and body tissues.
• The condition of raised blood uric acid is called hyperuricaemia.
• Regularly drinking alcohol interferes with the removal of uric acid from the body and can increase the risk for developing gout.
• Higher than normal levels of uric acid can be part of the inherited make-up of some families
• Less commonly, longstanding kidney disease may result in high blood levels of uric acid.
• High alcohol intake
• Eating too many foods rich in purines can cause or aggravate gout in some people.

Symptoms of Gout

Common symptoms include:

• Inflammation
• Pain
• Redness
• Stiffness
• Swelling
• The small joint at the base of the big toe is the most common site of an acute gout attack.
• Uric acid crystals can deposit in tiny fluid-filled sacs (bursae) around the joints.
• Tenderness can be intense so that even a blanket touching the skin over the affected joint can be unbearable.
• Patients can develop fever with the acute gout attacks.

Treatment of Gout

Some treatment of Gout:

• Offal foods such as liver, kidneys, tripe, sweetbreads and tongue.
• Excessive amounts of red meat.
• Shellfish, fish roe and scallops.
• Medication for high blood pressure may need to be altered.
• In most cases, gout is not treated unless it occurs frequently.
• Colchicine and probenecid (Benemid®) may be used alone or in combination (e.g., Colbenemid®) when other medications do not relieve symptoms.
• The most common treatments for an acute attack of gout are high doses of nonsteroidal anti-inflammatory drugs (NSAIDs) taken orally (by mouth) or corticosteroids, which are taken orally or injected into the affected joint.
• The most commonly prescribed corticosteroid is prednisone.