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Everything You Need To Know About Gout

Summary

Gout is a common form of arthritis characterised by recurrent, sudden attacks of extreme pain, swelling and redness. Pain often occurs in the big toe, knee, ankle, elbow and other joints. Gout is caused by a build-up of a waste product, uric acid, in the bloodstream. Most of the time, having too much uric acid isn't harmful. Many people with high levels in their blood never get gout. However, when excess uric acid crystallizes and settles in joints, tendons, and surrounding tissues it will often trigger inflammation, pain and swelling. Your chances of getting gout are higher if you are overweight, drink too much alcohol, or eat too much meat and fish that are high in chemicals called purines. Other causes of gout can include dehydration and the use of diuretics (fluid tablets), which can cause the retention of too much uric acid.

Symptoms and triggers

The most common sign of gout is a nighttime attack of swelling, tenderness, redness, and sharp pain in your big toe. You can also get gout attacks in your foot, ankle, or knees, or other joints. The attacks can last a few days or many weeks before the pain goes away. Another attack may not happen for months or years. Gout is more common in men, and often several men of the one family can be affected by gout.

A person with gout is more likely to have an attack when they:

  • have elevated levels of urate in the blood
  • consume too much alcohol (particularly beer)
  • consume a diet high in ‘purines’ such as meat, sweetbreads, offal, shellfish, and fructose (found in fruit juices and soft drinks sweetened with corn syrup)
  • are obese
  • use diuretics
  • injure a joint
  • have an operation
  • become dehydrated
  • are unwell with a fever
  • crash diet or fast

Gout has become more common in recent decades. The increase is believed to be due to increasing risk factors in the population, such as metabolic syndrome, longer life expectancy, and changes in diet. Gout was historically known as "the disease of kings" or "rich man's disease."

Treatment and management

The initial aim of treatment is to settle the symptoms of an acute attack. To do this your doctor can give you a shot of corticosteroids or prescribe a large daily dose of one or more medicines. The doses will get smaller as your symptoms go away. Relief from a gout attack often begins within 24 hours if you start treatment right away. Ice applied for 20 to 30 minutes several times a day decreases pain. To further ease the pain during a gout attack, rest the joint that hurts. Taking ibuprofen or another anti-inflammatory medicine can also help you feel better but DO NOT take aspirin. Aspirin can make gout worse by raising the uric acid level in the blood.

If you have frequent episodes of gout, your doctor can prescribe a medicine to reduce uric acid buildup in your blood and increase the excretion of uric acid to prevent future attack. Lowering uric acid levels can cure the disease. Paying attention to what you eat may help you manage your gout. Eat moderate amounts of a healthy mix of foods to control your weight and get the nutrients you need. Limit daily intake of meat, seafood, and alcohol (especially beer) an drink plenty of water and other fluids.

The benefits of reducing uric acid in the blood long term include:

  • slowing the progress or risk of kidney disease, which may be caused by deposits of urate in the kidneys
  • possibly reducing the risk of heart disease