It is a condition caused by deposition of uric acid crystals in a joint leading to inflammation and swelling of that joint. It is a kind of arthritis which begins suddenly.

It normally affects 1 in 40 adults, most commonly men between ages of 30 to 60 years.

Typical gout attack is characterized by sudden onset of severe pain. Acute attack of gout would reach its peak in 12-24 hours and if left untreated will resolve in about one to two weeks. Repeated instances of attack is known as chronic gout.

Cause:

The buildup of uric acid crystals in the joint leads to gouty arthritis. Uric acid is a byproduct of purine metabolism. Purines are substances in our body and are also found in food. Uric acid is excreted by kidneys. If excess of uric acid is present in the bloodstream it is known as hyperuricemia and left untreated will lead to acute attacks of gout.

Symptoms:

  • Swelling
  • Rapid onset of pain  
  • Redness and warmth
  • Stiffness in joints or limited range of movements
  • Fever
  • Disturbed sleep due to pain

Risk factors:

  • Diet: risk gout attack is more seen in people who eat food high in purine such as meats, seafood and vegetables and fruits containing fructose.
  • Alcohol use: alcohol decreases the ability to flush out the uric acid
  • Excess weight: people who are obese are at risk of gout attacks
  • Age and sex: more common in men than women because women have low levels of uric acid and mostly men are affected by the age of 30 to 60 years and women develop after menopause
  • Family history: if other members of your family have gout, your chances of developing gout are more.
  • Medications: diuretics and aspirin derivative drugs increase the levels of uric acid

Diagnosis:

Physical examination: doctor would look for swelling, redness and yellowish bumps under skin and limited range of motion and may suggest one or more of the tests mentioned below to confirm the diagnosis

  • Blood or urine test
  • X-ray
  • Synovial biopsy
  • Joint fluid analysis  

Treatment:

Remedies to reduce intense pain and swelling are

  • Apply ice over the joint will relieve the discomfort
  • Avoid putting pressure over that joint
  • Rest and elevation of the leg will help u in reducing the swelling

Medications for acute pain:

  • NSAIDS is indicated for most of the acute cases to relieve the pain
  • Colchicine is also used in treating acute attack of gout
  • Corticosteroid injections are indicated in cases who are unable to take  NSAIDS and colchicine . The drug is directly injected in to the joint which help in reducing the inflammation and pain

Medications to prevent gout complications:

  • drugs like allopurinol and febuxostat are prescribed to limit the amount of uric acid production in the body
  • Medicines like probenecid are prescribed  for efficient removal of the uric acid from the body

Preventive measures:

  • Drink plenty of water
  • Avoid alcohol
  • Limit intake of meat and seafood
  • Reduce weight
  • Supplementing with vitamin-C

If you experience sudden, intense pain in a joint, call your doctor. Gout that goes untreated can lead to worsening pain and joint damage. Seek medical care immediately

Dr.Chandrashekar

Reference: https://www.mayoclinic.org/diseases-conditions/gout/diagnosis-treatment/drc-20372903https://www.mayoclinic.org/diseases-conditions/gout/diagnosis-treatment/drc-20372903

https://www.arthritis.org/about-arthritis/types/gout/what-is-gout.php

https://www.medicinenet.com/gout_gouty_arthritis/article.htm

https://www.arthritiscare.org.uk/do-i-have-arthritis/a-z-of-types/54-gout

 

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