What Is Gout?

Gout is a form of arthritis that causes sudden, severe attacks of pain, tenderness, redness, warmth, and swelling (inflammation) in some joints due to deposition of uric acid crystals. 

The large toe is most often affected, but gout can also affect other joints in the leg (knee, ankle, foot) and less often in the arms (hand, wrist, and elbow).

What Causes Gout?

Diet and excessive drinking of alcohol can contribute to the development of gout, they are not the main cause of the disorder.

Gout results from abnormal deposits of sodium urate crystals around the joint cartilage and their later release into the joint fluid. 

Urate crystals can also form in the kidney, causing kidney stones.

Uric acid comes from the natural breakdown of RNA and DNA (the genetic material in cells). Some foods contain large amounts of uric acid, especially red meats and internal organs (such as liver and kidneys), some shellfish, and anchovies. 

Patients who eat more meat and fish (and less dairy) or drink more beer and liquor seem to be more prone to gout.

Who Is Affected By Gout?

Men (usually over age 40) and women after menopause

People who are overweight

People who frequently drink alcohol

When gout affects women, it is usually after menopause, especially in women who are taking certain medicines. 

Younger patients may be affected by gout if they have been taking certain medicines for long periods of time, frequently drink alcoholic beverages, or have certain genetic disorders.

How Is Gout Diagnosed?

Gout cannot be diagnosed simply from a blood test, since many people have elevated blood uric acid levels, but never develop gout.

Gout is diagnosed from the fluid withdrawn from an inflamed joint by an expert/best rheumatologist.

• The fluid is observed under a microscope for sodium urate crystals. 
• Removing the fluid may reduce pressure within the joint and thereby reduce pain.
• A lack of crystals does not necessarily rule out a diagnosis of gout.
• Since gout can cause chronic joint pain and involve other joints, it is extremely important that an accurate diagnosis be made. Then, your doctor can prescribe the appropriate specific treatment.

How Is Gout Treated?

There is no cure for gout, but it can be treated and controlled. Symptoms are often dramatically improved within 24 hours after treatment has begun. 

Gout is mainly treated with medicine. 

NSAIDs such as diclofenac, brufen usually reduce inflammation and pain within hours. 

Corticosteroids may be prescribed for people who cannot take NSAIDs. Steroids also work by decreasing inflammation. Steroids can be injected into the affected joint or given as pills. 

Colchicine is sometimes used in low doses for a long period of time to reduce the risk of recurrent attacks of gout

If you have kidney disease, heart failure, diabetes, ulcer disease or other chronic conditions, the choice of therapy to treat the gout is affected.

Drugs that lower the level of uric acid in the blood. (Examples are allopurinol, probenecid and febuxostat). 

These drugs are recommended for patients who have had multiple attacks of gout or kidney stones due to uric acid.

The goal of treatment is to reduce the uric acid level to less than 6 mg/dL. 

If any rash or itching develops while taking allopurinol, the medicine should be stopped immediately and your arthritis doctor/arthritis specialist/rheumatologist notified.

Can Gout Be Treated Through Diet?

Dietary changes for most people do not play a major role in controlling their uric acid levels. 

However, limiting certain foods, such as fructose containing corn syrup, red meat, beer that cause an increased production of uric acid and reducing alcohol intake are often helpful. Certain foods likes cherries, low fat diary products can decrease uric acid levels.