Gout

Gout - also known as "gouty arthritis - is one of the most common forms of joint inflammation. It is caused by a metabolic disturbance resulting in accumulation of uric acid crystals in small joints, which in turn causes joint inflammation, swelling, pain and redness. 

Gout usually occurs in areas where circulation is poor - most often in the big toe - and commonly affects people who are obese and/or who have diabetes, sickle cell anemia or kidney disease. It may also arise as a consequence of drug therapy that affects uric acid excretion. Men and postmenopausal women are also at greater risk for gout.

Signs & Symptoms

The symptoms of gout depend on how far the condition has progressed. The three main stages of gout are asymptomatic, acute, and chronic:

- Asymptomatic gout has, as the name suggests, no symptoms. Uric acid levels in the blood may be elevated, but treatment is usually not required.

- Acute gout is characterized by sudden onset of symptoms, of ten at night. It usually affects only one or a few joints, and the pain may be experienced as crushing or throbbing and is often quite intense. Other symptoms include sensitivity, redness or warmth around the joint, and joint stiffness.

- Chronic gout symptoms are similar to those of acute gout, but occur more often. Recurrence of gout episodes may lead to the joint becoming deformed and limited in motion. Usually after some years, tophi (uric acid deposits) may develop in tissues. 

If acute gout progresses to chronic gout, the intermediate stage may be referred to as intercritical gout.

In most attack of gout, pain subsides within a matter of days, although in people who experience attacks more often, symptoms may last longer.

Acute gout may be diagnosed through physical examination of the joints. Additional tests include uric acid testing (blood or urine tests), synovial-fluid testing (for uric acid crystals), and a blood differential (to test for neutrophils, a type of white blood cell found at higher levels in gout). 

X-rays may not be reliable in diagnosing gout, as x-rays of affected joints may appear normal.

How to Treat Gout

Taking non-steroidal anti-inflammatory drugs (NSAIDs) at the first sign of a gout-attack will help to relieve pain. Applying an ice-pack and elevating the affected limb may also offer relief, and using a cane when walking will help by reducing pressure on the joint.

Diet also plays a significant role in preventing gout: people who have a very high-protein diet, and people who drink large amounts of alcohol, are at a higher risk of gout. Eating a well-balanced diet and cutting down on alcohol intake may help to prevent attacks.

Drug treatment of gout includes drugs that will relieve pain (such as NSAIDs, codeine or other analgesics and steroids), and drugs that may prevent attacks, such as colchicine or allopurinol. Colchicine minimizes the inflammation due to uric acid crystal accumulation in the joint (how exactly it works is not known). Allopurinol prevents formation of uric acid by blocking an enzyme required to make it. Both drugs should be taken with doctor-recommended amounts of water, to minimize the risk of kidney-stone formation.

Doctors also treat chronic gout with probenecid or sulfinpyrazone, which decrease uric acid levels.

Gout Treatment Products from Netpharmacy:

Immediate Relief

Maintenance

See Your Doctor

If you have (or suspect you have) gout, or if you have gout and your attacks are still occurring (or worsening) despite drug therapy, see your health care provider. He or she will conduct a physical examination and may order additional tests to confirm the diagnosis.

If you have been diagnosed with gout, regular visits to your health care provider are advisable, to monitor your condition.

Helpful Links

National Center for Health Statistics - Arthritis Related Statistics

National Center for Health Statistics - Arthritis Types

U.S. Food and Drug Administration - Help Your Arthritis Treatment Work

The Arthritis Foundation (or call toll-free on 1-800-283-7800)