What is Gout?
A form of arthritis that is a painful inflammation and swelling of the joints caused by the buildup of uric acid in the body. Certain foods cause gout so diet plays a role. Treatment of gout can be acheived through medication and proper diet.
The most common gout symptom is sudden, severe attacks of pain, tenderness, redness, warmth and swelling in some joints. It usually affects one joint at a time, especially the joint of the big toe, but can also affect the knee, ankle, foot, hand, wrist and elbow. Deposits of uric acid, called tophi, can appear as lumps under the skin around the joints and at the rim of the ear. In addition, uric acid crystals can also collect in the kidneys and cause kidney stones.
Causes of Gout
This is one of the few types of arthritis where the cause is known. It results from deposits of needle-like crystals of uric acid in the connective tissue, joint spaces, or both. Normally this is a byproduct of the breakdown of purines or waste products in the body. Normally uric acid breaks down in the blood and is eliminated in urine. When the body increases its production of uric acid or if the kidneys do not eliminate enough of it from the body, levels build up. This is called hyperuricemia. Hyperuricemia is not a disease and is not dangerous. However, if excess uric acid crystals form as a result of hyperuricemia, gout can develop.
Some people may benefit from a reduction of purine rich foods. These include beer and other alcoholic beverages, anchovies, sardines (in oil), fish roes, herring, yeast, organ meats (e.g., liver, kidneys), legumes (e.g., dried beans, peas, and soybeans), meat extracts, consommé, gravies, mushrooms, spinach, asparagus, cauliflower, and poultry. Weight loss can help reduce uric acid levels in those people that are overweight.
Although there is no cure, most people with gout can keep it under control and lead normal lives. Treatment may consist of one treatment or a combination of treatments.
Nonsteroidal anti-inflammatory drugs (NSAIDs) block prostaglandins, the substances that dilate blood vessels and cause inflammation and pain. They are taken orally at their highest safe dosage as long as symptoms persist and for three or four days after. There are dozens of NSAIDs. Indomethacin (Indocin) is the usual choice.
Colchicine, a derivative of the autumn crocus, has been used to treat gout for thousands of years. This drug relieves the pain and swelling and can help prevent future attacks. Although highly effective, it is no longer the first treatment choice due to the potential for unpleasant side effects.
Corticosteroids may be used if NSAIDs are not tolerated.
Allopurinol (Lopurin, Zyloprim) blocks uric acid production and is the drug most often used in long-term treatment for older patients and those with high levels of excreted uric acid.
How is it diagnosed?
Standard diagnostic tools for gout may include a medical history and physical examination, a blood test for hyperuricemia, and urine sample. For a definitive diagnosis, a sample of synovial fluid from the affected joint is required. X-rays can provide helpful information in some cases.
What research is being done?
Scientists are studying whether other NSAIDs are effective in treating gout and are analyzing new compounds to develop safe, effective medicines to treat gout and other rheumatic diseases. For example, researchers are testing to determine whether fish oil supplements reduce the risk of gout. They are also studying the structure of the enzymes that break down purines in the body, in hopes of achieving a better understanding of the enzyme defects that can cause gout.
Some of the related information found on Arthritis Insight:
Get support from others coping with gout please visit our Gout Message Boards.
For more information:
Well-Connected Report-Gout, Copyright © Nidus Information Services, Inc. 1999
American College of Rheumatology
The National Institute of Arthritis and Musculoskeletal diseases, Questions & Answers about Gout