Gout: Treatment, symptoms, advice and help

About gout

Gout is a type of arthritis characterized by the accumulation of uric acid crystals in the joints. It may affect any joint in the body but is commonly manifested in the joint of the big toe. It is a painful condition and typically manifests in episodic fashion. Gout may lead to irreversible joint damage if not managed timely.

Gout: Incidence, age and sex

Individuals of any age group may be affected by gouty arthritis. However it is more common in adults in the 40s and 50s. Men are more prone to be afflicted with gout as compared with women.

Signs and symptoms of gout: Diagnosis

Gout is a longstanding disease with acute episodes and asymptomatic periods in between such episodes. Gout begins with the presence of increased level of uric acid in blood. This is a symptom-free period which progresses to acute episode coinciding with deposition of uric acid crystals in joint. The acute episode is usually sudden in onset and manifests with complaints of pain and swelling in the joint area, along with redness of skin around the joint. This acute episode usually lasts for 5 to 10 days. The affected individual remains symptom free till the next episode.

This may later progress to chronic state wherein the individual may experience persistent discomfort or stiffness in the joints. Movements of the joints may be hampered and skin over joint may exhibit pus forming lesions.

Gout shows a tendency towards affliction of the large joint of the big toe. However other joints like ankle, foot, hand and wrist may also be affected.

Gout can be detected by detailed history and examination of affected joint (during acute episode). The diagnosis can be corroborated with increased level of uric acid in the blood or presence of urate crystals in the joint fluid. Imaging modality like X-rays may be helpful in individuals with longstanding gout wherein some joint changes may be observed.

Causes and prevention of gout

The exact cause of gout is not quite clear. However it is understood that increased levels of uric acid in body causes gout. This uric acid imbalance may take place either due to its increased production or its reduced excretion via kidneys. Normally the uric acid is a waste product of breakdown of purines. Certain risk factors like obesity, excessive alcohol consumption, starvation, kidney disorder or surgical trauma may increase the chances of gout. Furthermore drugs like thiazide diuretics or chemotherapeutic medications may also increase the risk of gout.

Gout: Complications

The main complications of gout include irreversible damage of the affected joint, if left untreated for a long time. Moreover, gout may also progress to cause kidney damage in some individuals.

Gout: Treatment

The management of gout depends upon the causative factor. So the first and foremost step is to manage and eliminate the cause. Medications like NSAIDs which help in reducing pain, swelling and inflammation of joint are usually prescribed for symptomatic relief. Moreover gout medications like Probenecid, Allopurinol, which help in reducing urate synthesis, may also be given to the affected individual. Lifestyle modifications which include alcohol restriction, managing weight and avoiding crash diet usually helps in preventing future episodes of gout. It is advisable to consult a nutritionist for dietary advice. Avoidance of sardines, red meat, peas, legumes and beans helps in reducing urate formation in body. Drinking plenty of fluids may help in effective elimination of uric acid from kidneys. The prognosis of gout is good in most of the individuals, when diagnosed and managed early in course of disease.