Gout is the most common cause of inflammatory arthritis in men over 40 years of age, it is a condition in which uric acid gets deposited in the joint and causes severe, recurrent joint pain.
When the uric acid level in the blood is high, it deposits in the joint and causes inflammation in the joint resulting in excruciating pain. Gout most commonly affects the foot, although any joint in the body can get affected. Pain starts as a dull aching pain but soon develops into very severe throbbing pain which may be one of the most severe pain one has ever experienced.Pain of gout usually subsides in 2-3 days and the patient can resume normal life. If uric acid levels are not controlled other joints get affected.
Diagnosing gout doctor has to aspirate fluid from the affected joint. This fluid will show needle shaped crystals under the microscope. Gout cannot be diagnosed based only on elevated uric acid levels in the blood.Serum uric acid levels will be elevated at some time in almost all patients with gout, but the level can be normal at the time of an acute gouty attack in as many as 30% of patients
Gout if not treated properly can result in kidney stones and result in kidney failure. Moreover, these patients are at higher risk of heart attacks. Uric acid can get deposited beneath the skin resulting in formation of a chalky substance called “Tophi”
First priority in a patient who has a severe attack of gout is to relieve his pain. For this the best available method is to give intraraticular injections. Other drugs available are NSAIDs, Cochicine etc. The primary aim of long term management of gout is to decrease the uric acid levels to normal. Weight reduction helps in reducing the uric acid levels in the blood.
Foods like seafood, soft drinks like Coca cola/Pepsi, alcohol, etc. increases the uric acid level in the blood and has to be avoided. Taking lot of milk decreases uric acid level in the blood. Drinking lots of water also can help gout patients by increasing the uric acid excretion. To decrease the uric acid levels like Allopurinol or newer drugs like Febuxostat has to be used in the majority of patients with gout. The target is to keep the level of uric acid below 6 mg %