GOUT

Gout is a common form of arthritis. It appears suddenly and causes severe pain and swelling.

Gout usually affects only one joint at a time, most frequently the joint in the big toe, although it can affect other joints as well. It does not “spread” from one joint to another.

Cause

Gout is caused by the build-up of too much uric acid in the body. Uric acid is formed by the body when it breaks down waste products called purines. The uric acid forms microscopic crystals in the joints that cause pain and inflammation.

This disease can be inherited or it can develop as a complication of another illness. Some of the causes include:

High alcohol intake.

Eating too many foods that are high in purines (liver, kidneys and other organ meat, anchovies, sardines in oil, herring, shellfish, dried beans and peas, mushrooms, spinach, asparagus and cauliflower, yeast, gravies and consommés).

Obesity

Crash dieting, which can raise uric acid levels in the blood.

Some medications used to treat high blood pressure.

Risk Factors

Gender and Age: Gout affects mostly men over the age of 40. It occasionally develops in women, but this usually occurs only after menopause.

Family history of high uric acid levels.

Symptoms

Sudden join pain and swelling, most commonly in the big toe joint (but can also occur in the feet, fingers, wrists, elbows, knees, or ankles) which lasts for 5 to 10 days.

Symptoms usually occur in the middle of the night.

The joint becomes stiff and hot, and appears very shiny and has a reddish or purple appearance.

Fever as high as 102 degrees with or without chills can also occur.

The slightest pressure on the area can result in severe pain.

A period of no symptoms, followed by additional acute episodes usually occurs.

At first, episodes usually are few and far between, but left untreated, attacks may occur more frequently and may last for longer durations.

After several acute episodes over a period of years, persistent stiffness, swelling and pain can occur.

Complications

In some people with high uric acid levels, in addition to the possibility to developing gout, they are at higher risk for developing:

Tophi, which are large deposits of uric acid crystals that build up in and near joints. These deposits look like lumps beneath the skin. They can also develop in or near other joints and also on the outer edges of the ears. If not treated, tophi can cause joint damage.

Kidney stones, which can form from uric acid crystals if fluid intake is not sufficient to flush the crystals from the body.

Summary

Gout, once diagnosed, is a chronic condition, however, with proper diet and use of medication, the disease can be controlled and future episodes avoided.