What is Gout?
Gout is a rheumatic condition that predominantly affects middle-aged men. It is ten times more common in men than in women. The most common site for an attack of gout is the joint at the base of the big toe. An acute attack of gout can be extremely painful.
Cause of gout
Gout is caused by a build-up of uric acid in the blood. This results in the formation of sodium urate crystals in the joints. Uric acid itself if a by-product of the breakdown of certain types of waste products. In the vast majority of people, it is eliminated from the body during urination. However, among those who are susceptible to gout, the uric acid builds up in the bloodstream and deposits itself in crystal form in the joints. The crystals cause irritation within the joint giving rise to the acute inflammation we recognise as gout.
Diagnosis of Gout
Diagnosis of gout involves inserting a needle into the affected joint and drawing a sample of the fluid that lubricates the joint (called synovial fluid). The fluid is then analyzed under a microscope to determine if uric acid crystals are present and if a blood test (uric acid) is required.
Treatment for Gout
There are a number of steps you can take to reduce the pain and swelling of a gout attack. Left untreated, attacks of gout may become more frequent and last for longer.
- Raise and rest your joint. You shouldn’t do any vigorous physical activity. Sometimes your doctor may give you a splint to wear to stop you moving your joint.
- Keep your joint cool and don’t cover it. Apply ice wrapped in a towel to your joint for about 20 minutes to help reduce swelling. You shouldn’t apply ice directly to your skin as it can damage your skin. If you need to repeat this, let your joint return to its normal temperature first.
There are some medicines your doctor can prescribe to help ease the pain and swelling of an attack of gout.
Non-steroidal anti-inflammatory drugs (NSAIDs), may relieve pain and inflammation. If you have a heart condition, high blood pressure, kidney disease, lung disease or if you’re over 65, these medicines may be harmful so you should talk to your doctor about taking them.
Alternatively, your doctor may recommend a steroid injection if you have gout in a large joint (such as your knee).
If you have repeat attacks of gout, there are medicines you can take to help to prevent it.
Prevention of gout
Identifying anything that brings on an attack of gout and not doing these things is very important.
For example, you:
- shouldn’t eat foods that are very high in purines, such as liver, kidney and seafood (especially oily fish such as mackerel, sardines and anchovies), and certain vegetables (asparagus, cauliflower, lentils, mushrooms, oatmeal and spinach) – ask your doctor or a dietician for more advice
- shouldn’t drink too much alcohol – especially beer, stout, port and fortified wines
- should eat a well-balanced diet and do regular physical activity to lose excess weight
- should drink enough water