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What is it?

Gout is an inflammation of the joints caused by high blood levels of uric acid.

Who gets it?

Gout occurs in about 2% of the population. It’s about twice as common in men than in women. In men it tends to occur in the ages 30-45, while in women it’s more common in the ages 55-70.

The are a few risk factors which can increase your risk of developing gout -

1. Obesity
2. High blood pressure
3. Injury or recent surgery
4. Fasting
5. Consuming excess amount of alcohol on a regular basis (especially beer, whiskey, gin, vodka, rum).
6. Overeating
7. Eating large amounts of meat and seafood
8. Taking medications which can cause uric acid in the blood to rise (especially diuretics)

What causes it?

Gout is caused by having too much uric acid (also called urate) in the blood. When the levels of uric acid in the blood are high, they can form hard crystals, which can then accumulate in the joints.

 

Uric acid crystals. These accumulate inside the joints, causing the disease. Photo by Bobjgalindo.

Our body tries to dispose of those crystals by sending white blood cells to “eat” them. These cells cause inflammation in the joint, which brings about the disease.

How does it feel?

Gout occurs as attacks of sudden very severe joint pain, sometimes with redness, swelling, and tenderness of the joint. The attack is usually worst in the first hours, and improves completely within days to weeks.

Gout usually occurs in a single joint in the body. Usually it’s the big toe, the ankle or the knee.

After a few years with these attacks, uric acid crystals accumulate in joints, bones and cartilage in the body. This causes masses known as tophi.

A person with gout. You can see tophi in his elbow. Photo by NickGorton.

How is it discovered?

To discover if the inflammation in the joint is caused by gout, the doctor uses a needle and a syringe to take a sample of the fluid in the joint. Then this sample is looked at under the microscope to see the uric acid crystals.

Another thing your doctor can do is test your blood for levels of uric acid, to see if it’s high.

How is it treated?

There is a treatment for the attack itself and a treatment which is taken between attacks to prevent further attacks from happening:

1. Treatment for the attacks – To stop an attack a few drugs can be used, such as steroids, non-steroidal anti-inflammatory drugs (examples of those include ibuprofen and indomethacin) and a drug called colchicine (we’ve already talked about colchicine before, as a treatment for Familial Mediterranean Fever).
2. Treatment between the attacks – There are drugs that can lower the amount of uric acid in the blood. Examples of those include allopurinol, and probenecid.

What happens after treatment?

Relief from an attack usually begins within 24 hours if the treatment is started early in the attack. Taking allopurinol and following the measures below under “how do I prevent it” can help achieve a normal, attacks-free, life.

The bottom line – How do I avoid it?

Because of the risk factors above, if you’re prone to gout, the following things can lower your chances of developing it -

1. Losing weight – Since obesity is a risk factor for gout. However, starvation or fad diets aren’t recommended.
2. Reducing the amount of red meat and seafood in your diet
3. Increasing the  amount of low-fat dairy products and complex carbohydrates in the diet.
4. Drinking less beer, gin, vodka etc. (Drinking wine moderately, on the other hand (one to two 5 ounce servings a day) is not connected with an increase in gout attacks).
5. Drinking less drinks which contain a high level of fructose corn syrup (such as some types of non-diet soda). These drinks increase the level of uric acid in the blood.

This video sums everything up –

There are a few blogs you can visit to read more about gout: The gout diet blog, Beating gout blog, the gout blog and gout symptoms and cures blog.

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