Uric Acid (Gout)
Gout is a chronic auto inflammatory disease with regular acute flares which causes severe pain and joint inflammation. It mainly occurs due to high content of uric acid in the blood, this leads to accumulation of uric acid crystals in the joints and surrounding tissues that causes inflammation. It is a type of arthritis that affects the common joints such as big toe, ankle and knee.
Causes of Gout:
It is caused by excess uric acid in the body that leads to the development of monosodium urate crytal deposits in the joints.
Uric acid is a natural waste product that generates from the foods that contain purines. In a normal person uric acid is flushed out through the kidneys and passes out in urine. If you consume foods which are high in purine, your body sometimes cannot get rid of this by-product and uric acid will build up in the blood. When the level of uric acid is high it is known as hyperuricemia and it may lead to the gout.
Gout is caused by different factors such as diet, genetics, obesity, stress, high consumption of alcohol, medications. It also happens with people who have other healthy issues like diabetics, heart failure, kidney problems, and hypertension.
The extra uric acid forms crystals that are sharp and pokey causes joint pain and swelling.
Symptoms of gout:
- Apart from inflammation, swelling and pain, acute gout attacks very fast with intense joint pain within 8 to 12 hours.
- Gout first occurs in legs or feet and often affects a single joint mainly the joint of big toe.
- You may find redness in the skin over a joint.
- Might experience mild fever and chills
- You may have pain in your back and side
- Gout may also cause kidney stones.
- Lumps of urate crystal deposits formed under the skin.
How is gout diagnosed?
Your doctor will ask to do few tests like
Joint fluid tests: a fluid sample is taken from the affected joint and examined under a microscope to find the urate crystals. Some infections may have similar symptoms like gout, in such cases, the doctor may check for bacteria in joint fluid.
Blood test: blood test is done to find out the level of uric acid in the blood. Sometimes these tests are confusing because some patients may have high uric acid level and they never experienced gout. And for some patients they have symptoms of gout but they do not have high level of uric acid.
X-ray imaging: x rays help in finding out if there is any other inflammation in the joints.
Ultrasound and CT scan: this technique is used to detect urate crystal in the joint or in a tophus.
Treatment for gout:
Acute gout will last within 3 to 10 days with or without medicines. Some may get only once in their lifetime and some may get repeatedly due to their change in diet or any other health issues. For acute gout, medicines are given to reduce inflammation and pain because they do not have any high uric acid levels. If the level of gout is high then long term medication is must to maintain the uric acid levels.
For acute level of gout
- Non-steroidal anti-inflammatory medication is given.
- To relieve from pain and inflammation oral medication- Colchicines is given.
- Hydration
For life time chronic gout:
- Need to do lifestyle modifications by avoiding alcohol, reducing protein intake, reduce weight if you are obese.
- Long term medications are given to maintain uric acid level in blood. You may sometimes need to continue medicines even if your gout is better because there can be low lying inflammation between attacks. The crystal deposits can become big in size and eventually become hard and it may damage the joint. So the medicines will help you to maintain the uric acid levels.
Prevention of gout:
To treat and prevent acute gout, medication is the most effective way that can prevent recurrent attacks. However, by making certain lifestyle changes may help in prevention of gout such as
Completely avoid alcohol, avoid cool drinks and juices with sugar, Instead high intake of fluids and water will help.
Reduce intake of foods which are high in purines like red meat and sea foods.
Exercise regularly and maintain a healthy weight.
Conclusion:
Gout is a serious and painful problem which cannot be cured completely. It is a long term disease that can only be controlled with the combination of medicines to control the uric acid level and anti inflammation drugs to control the flare- up. By lowering the levels of uric acid in the blood most people do not develop the fourth and most disabling stage of the disease.
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