Facts about Gout

Gout is a painful type of arthritis which occurs when there is an excess of uric acid in the joints.  It is also referred to as “gouty arthritis.”  Uric acid is normally found in the tissues and blood and is formed as a result of the metabolism of purines found in many of the foods we eat.  Uric acid is normally excreted in the urine, however there are certain conditions which inhibit this metabolic pathway and cause it to build up in the bloodstream and joints.

A gout attack is an acute event which occurs unexpectedly when there is significant accumulation of uric acid that can crystallize into sharp and jagged particles concentrated in the joints.  The most common areas where this may occur are the base of the big toe, knee, fingers, elbow or wrist.  If the condition is treated, it usually subsides within a couple of days, however in some; it can last for several weeks.  If untreated, gout will often recur and become more frequent.

There are several symptoms that indicate gout attack and can include redness, swelling, intense pain and discomfort in the joint and tenderness so severe that even the slightest touch can be unbearable.  There can also be chills and fever.  It is very important to see your physician for severe joint pain especially if it lasts a week or more.

A high level of uric acid is referred to as hyperuricaemia and some people experience it without ever having any pain.  This condition is often genetic and runs in families of gout sufferers.  In other words, one can have high levels of uric acid and not experience the pain of gout.

Prevalence of Gout

The prevalence of gout is largely dependent on gender and culture.  Middle-aged men are nine times more likely to develop gout than women and it is more common in those who come from the South Pacific and Australia.  In addition, if one is overweight and has high blood pressure, the chances are even greater.  Women who do develop gout have typically already gone through menopause.

The following risk factors can also contribute to gout.  These include medications such as acetylsalicylic acid (aspirin), niacin and certain diuretics as well as certain diseases like leukemia, hemoglobin disorders and lymphomas.  Current studies are exploring the relationship between hypothyroidism (low thyroid hormone levels) and gout.  Despite these risk factors, there are some simple precautions one can take to reduce the risk of this painful condition:

• Drink plenty of water to prevent dehydration
• Limit the amount of foods that contain the highest levels of purine (anchovies, sardines, livers, sweetbreads)
• Limit the amount of alcohol consumed daily

There is only one sure way to determine if you are afflicted with gout and that is through fluid aspiration of the joint, which will reveal the presence of uric acid crystals.  If this is simply too painful to accomplish, a blood test will reveal the level of uric acid in the blood, although a blood test alone cannot be conclusive.

If you believe that you are experiencing an acute (or sudden) gout attack, you can mitigate some of the symptoms by taking acetaminophen (Tylenol) or a non-steroidal anti-inflammatory (NSAID) to minimize pain and swelling.  An ice pack and resting the joint can help as well.

Chronic gout is controlled by the use of steroids to reduce inflammation and Allopurinol which works to decrease the production of uric acid in the body.  Other medications that control the amount of uric acid excreted in the urine are uricosuric drugs such as Probenecid, which also control attacks of kidney stones.  The regular use of aspirin or ibuprofen is not encouraged as this may actually cause the gout to worsen.