Gout

What is gout?

It is a condition in which uric acid, a by product of normal metabolism rises above the normal levels, and gets accumulated as crystals in joints causing pain, swelling and redness.

Whom does it affect?

It mainly affects older males, the ratio of male: female is 4:1.

Which is the most common site for gouty arthritis?

The base of the big toe is the most common site for gout in the beginning.

What are the signs and symptoms of gout?

• Intense continuous pain in joints especially the big toe.
• Hot red swollen skin and feeling of pressure around the affected area and accompanied by stretching / tearing pain in the skin.

What are the causes I risk factors of gout?

Genetic factors: one out of 4 people have family history of gout.

Consuming purine rich food such as organ meats (liver, heart, kidney) beans, peas etc. excessive eating, drinking alcohol, medication that decrease body’s ability to remove uric acid like diuretics (water tablets), Vitamin D3, cyclosporine etc. also can precipitate gout. People with diabetes, high cholesterol, obesity are also in the risk group.

What can cause a flare up in gout?

• Having an infection
• Sustained joint injury
• Surgery or being hospitalized
• Increased alcohol intake
• Stress
• Dehydration

What are the medications for gout?

• NSAIDs (Non steroidal anti inflammatory drugs) like ibubrufen
• Cox 2 inhibitors (to be used with caution, due to cardio vascular complication)
• Uric acid synthesis inhibitors like allopurinol for life long to keep uric acid level below 6.
• Colchicine and low dose steroid for acute gout.
• Biological agents to block interleukins-1 in severe acute situations.

What should be done to prevent gout?

Avoid purine rich foods

• Control weight
• Increase fluid intake
• Limit alcohol / caffeine
• Fish oil is beneficial

What are the complications of untreated gout?

• Joint destruction
• Renal stone and renal failure
• Ulcerating tophi ( nodules in skin)
• Hypertension