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Gout

Gout is one of the most common forms of arthritis in the body. It most commonly causes inflammation of the joint of the big toe (1st metatarsal phalangeal joint), however, it can affect any joint. The first signs of gout are sudden with an acute attack which often comes on overnight.
Usually, within 12-24 hours there is severe pain and swelling of the joint affected.

Self Management

There are a number of things that you can do to help yourself manage gout:
– Take your medication as instructed by your doctor
– Reduce weight
– Take dietary advice to lower your intake of purines
Complications
If the uric acid levels have been high for a long time and acute attacks of gout has been frequent, there may be deposits of uric acid around the affected joint (and even elsewhere such as the ears) – these are called tophi. If they are present, there is an even greater need for long term drug treatment to lower the uric acid levels.

What are the Symptoms?

Gout usually only affects one joint at a time (sometimes two) – most often the feet and ankles. The joint at the base of the big toe is the most common site.

If there is no treatment the gout attack usually subsides in a week or so. After the first attack there may be intervals of many months or even years before there are other attacks. Over time these attacks tend to become more frequent and more severe and eventually may involve other and more joints. Eventually, without treatment, a state of chronic or continuous joint symptoms may develop with progressive joint damage.

Gout mostly affects men and is very rare in women until after menopause when it is seen quite often.

Gout is very painful. The joint becomes swollen and the skin over the joint can be shiny or glossy in appearance.

What Causes Gout?

The cause of gout is related to the physiology of uric acid, which is a chemical that is a natural part of the normal breaking down and building up of food and body tissues. When uric acid levels are higher, this is known as hyperuricaemia. Uric acid is normally dissolved in the blood, but when its high, microscopic crystals may be deposited in the joint. These crystals then set up the acute inflammation causes the gout.

As a result of this physiology, gout is common in those with hyperuricaemia.

There are many causes of this and include:

Some people just have higher levels and this is hereditary.

– Obesity
– High alcohol intake
– High intake of food that contain purines (purines are broken down into uric acid)
– Some of the drugs used to treat high blood pressure can precipitate a gouty attack.
– Those with kidney disease may also develop high levels of uric acid.

Being overweight is a risk factor, so weight loss may be very important.
High blood pressure (hypertension) is also a risk factor that your doctor may need to address.

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