Gout

Gout is a painful disease that usually affects one joint, more often the big toe. Other joints that may be involved are those of the feet, ankle, knee, wrist and elbow. Abnormal metabolism leads to collection of urate crystals in the joint, provoking an inflammatory reaction. Men are more affected, usually after 30, and there is often a familial tendency.

Among the factors that induce gout are diet, alcohol, surgery, infections, injury, kidney disease and medications like some diuretics (drugs to
Increase urine flow) and low-dose aspirin.

After repeated attacks, crystals of sodium urate can be found in the joint, the tissues around it, and in nodules called tophi in other parts of the body. A patient may notice tophi in the external ear. Urates can form kidney stones, leading to urinary problems.

Symptoms of Gout

The symptoms of gout include redness, swelling, increasing pain and stiffness of the affected joint. Taking alcohol or meats in a meal may precipitate an attack, which tends to occur at night and usually involves the big toe. Later the skin around the joint itches and peels off: After an attack there may be no symptoms for years.

But recurrences are usual. Chronic gout results in degenerative changes in the joint.

Lab tests show increased uric acid in blood and urine, and crystals in the tophi. X-rays show joint changes later on in the disease.

Treatment of Gout

Initial treatment aims at controlling inflammation and pain - with NSAIDs or other drugs like steroids, and rest. Later, drugs to increase excretion of uric acid and decrease its blood levels are given.

Long-term care helps reduce the number of attacks and their severity - by weight control, cutting down trigger factors like alcohol, and avoiding food and medications that increase uric acid levels.

A diet low in purine (a chemical substance which raises uric acid levels) is needed; therefore, meats and certain vegetables like beans, peas, spinach and cauliflower should be avoided.

Get information and clear advice from the doctor about dietary and other precautions, and of the possible complications of gout.

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