What is Gout?
Gout, also called gouty arthritis is a metabolic disease marked by urate deposits, which cause painfully arthritis joints. Most people dismiss gout as just a painful inflammation of the big toe resulting from over-indulgence in food and drink. In fact the causes are more complex, and if left untreated, gout can lead to serious bone and kidney damage.
Although the exact cause of primary gout remain unknown, its appears to be linked to an abnormally high amount of uric acid in the tissue fluids. Uric Acid is always present in the body as it is a product of certain foods when they are broken down and also of naturally worn out tissue cells.
Normally the gut and the kidneys excrete uric acid so that the level in the body remains constant. In patients suffering from gout, either too much uric acid is formed or it is inadequately excreted.
There are various reasons for an increase in uric acid formation. Certain foods rich in the chemicals known as purines will, after digestion, produce uric acid, an excess of which can lead to gout if the body does not excrete it efficiently.
High purine food include; sweetbreads, liver, kidney, meat extract, goose, duck, turkey, fish, lobster, sardines, herring, bloater and sprats. These foods are best avoided in large amounts, but if eaten in moderation their contribution is relatively slight. However, it is now known that the part played by diet is relatively small and other causes are far more likely.
The most common cause is the filtering process of the kidneys becoming inefficient at getting rid of uric acid. This can happen in some kidney troubles such as chronic NEPHRITIS or be due to the effect of certain drugs, such as diuretics.
Sometimes gout develops during the course of another diseases such as obesity, hypertension.
Gout develops in four stages:
Urate rise in blood.
Symptoms usually lasting for five to ten days.
Sudden attack of joint pain.
Joints feel, tender, hot, and look dusky red or cyanotic.
Intercritical - symptom-free intervals between gout attacks. most patients have second attack within 6 months to two years, but in some second attack does not occur for 5 to 10 years.
persistently painful joints with large urate deposits in the cartilage, membranes between the bones, tendons and soft tissues.
the skin over the tophus may ulcerate and release a chalky, white exudate or pus.
limited motion of affect joint.
Correct management seeks to terminate an acute attack, reduce hyperuricemia, and prevent recurrence, complications, and the formation of renal calculi. Colchicine is effective in reducing pain, swelling, and inflammation; pain often subside within 12 hours of treatment and its completely relieved in 48 hours.
Treatment for patient with acute gout consists of bed rest; immobilization and protection of the inflamed, painful joints.
Written by Medpages Editorial Team
Last Editorial Review: 18/1/2010