Medical Diseases List

Gout - Symptom, Causes, Treatment of Gout

Gout is a disturbance of the body's chemical balance in which chronic excess uric acid in the blood leads to deposits of needle-shaped urate crystals in and around joints and tendons. where they cause inflammation (gout is a form of arthritis). Blood uric acid is derived from the breakdown of body cells and protein in the diet.

Causes of Gout

Most gout is due to a disorder of kidney function that results in decreased excretion of urates in the urine. Reduced urine production in hot climates can contribute to the problem. The tendency to gout may be hereditary (1 in 5 sufferers has a close relative affected)

Symptoms of Gout

Acute gouty arthritis appears with-out warning. Attacks may be triggered by minor iruury. overindulgence in food or alcohol. surgery, fatigue, or physical or emotional stress. The first few attacks usually affect a single limb joint -classically in the ball of the foot, but the instep, ankle, knee, knuckles, wrists and elbows are also common sites. The gouty joint becomes hot, red, swollen and severely painful, though symptoms subside within a few days. Later attacks may affect several joints and last longer, and may be associated with fever and malaise. Without preventive treatment, several attacks may occur each year, and the affected joints may become stiff, deformed and permanently damaged. Patients with gout have an increased risk of developing URINARY STONES and damage due to urate crystals forming in the kidneys' filtering units.

Diagnosis of Gout

The features of acute gouty arthritis usually suggest the diagnosis. which can be confirmed by finding high levels of uric acid in the blood as well as urate crystals in joint tissues or fluid. Clumps of crystals, called gouty toph, give a characteristic X-ray picture and, if large, may be seen or felt under the skin beside a joint.

Treament of Gout

Acute gouty arthritis usually responds quickly to non-steroidal anti-inflammatory drugs and/or the drug colchicine. Severe attacks may require drainage of fluid from the affected joints with a syringe, followed by injection of CORTICOSTEROID DRUGS into the joint cavity. Rest and abundant fluid intake are recommended, Analgesics and splinting the affected joint help to relieve pain.

After the acute attack has subsided, the aim of treatment is to prevent recurrent attacks with daily doses of a drug that lowers blood uric acid by increasing its urinary excretion and/or blocks its production. Additional measures include high fluid intake(3 litres or more a day); drugs that keep the urine alkaline to reduce the risk of kidney stones (in acid urine, small uric acid crystals may come together to form stones or gravel); reduction of obesity, if present. to take the weight off affected joints; and reducing purines (food constituents that increase blood uric acid) in the diet. High-purine foods include anchovies, prawns, oysters, brains, offal and meat extracts. Existing tophi may be surgically removed.

Outlook of Gout

Adherence to modern treatment allows most patients to live a normal life, and chronic disabling gout is becoming a thing of the past.

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