What is gout-symptoms, diagnosis and treatment of gout

What is Gout?

Gout is a type of arthritis.

It can cause pain and swelling in the joints. At first, it tends to affect only one joint – most frequently the big toe. Gout is a form of inflammatory arthritis that develops in some people who have high levels of uric acid in the blood.

Breaking down of certain food by our body produces a chemical called URIC ACID.Uric acid can form sharp needle-like crystals that build up in the joints and cause pain. Uric acid crystals can also form inside the tubes that carry urine from the kidneys to the bladder. These crystals can turn into “kidney stones” that can cause pain and problems with the flow of urine.Abnormality in managing the uric acid and crystallization of these compounds in joints can cause attacks of painful arthritis, kidney stones, and blockage of the kidney filtering tubules with uric acid crystals, leading to kidney failure.

What are the symptoms of gout?

Patients with gout get sudden attacks of severe pain, most often in the big toe, ankle, or knee. Normally, only one joint is affected, but some people have pain in more than one joint.  The small joint at the base of the big toe is the most common site for an attack. Gout flares tend to happen more often during the night. In some cases the joint may also turn red and swell.The pain from gout can be extreme. The pain and swelling are worst at the beginning of a gout flare.These painful attacks usually subside in hours to days, with or without medication.It is not clear how these painful attacks subside.

How to diagnose the gout?

To test you for gout, your doctor may take a sample of fluid from the joint that is in pain. Presence of the typical gout crystals in the fluid confirm you have gout. Even without checking fluid from a joint, the doctor  might still strongly suspect gout if:

  • You have had pain and swelling in one joint, especially the joint at the base of the big toe
  • Your blood tests show high levels of uric acid
  • Your symptoms completely go away between flares, at least when you first start having them

However , The most reliable test for gout is detecting uric acid crystals in the joint fluid obtained by joint aspiration. This procedure is performed with topical local anesthesia.

How is gout treated?

Treating gout requires a two-pronged approach that combines medications and lifestyle changes.

There are a few medicines that can reduce the pain and swelling caused by gout.Gout medicines work best if you take them as soon as symptoms start.

The medicines used to treat gout flares include:

  • NSAIDs – This is a large group of medicines that includes ibuprofen (sample brand names: Advil, Motrin) and indomethacin (brand name: Indocin). NSAIDs might not be safe for people with kidney or liver disease, or for people who have bleeding problems.
  • Colchicine .
  • Steroids.

Medications that lower uric acid are intended to prevent gout attacks and keep the condition from becoming chronic. you must ensure that your uric acid level gets low enough to dissolve the gout crystals. Taking these medications can be challenging – as uric acid levels drop, crystals in your joints may shift, triggering another attack. However, sticking with your treatment plan is the best way to prevent future attacks. Allopurinol, febuxostat, and probenecid can actually increase gout pain when you first start taking them. To prevent these flares, your doctor might suggest that you take NSAIDs like low doses of colchicine when you start the medicines.

You  must check your uric acid levels regularly. This is to make sure the medicines are working and you are taking the right dose.

what Can I do anything  to prevent gout flares?

  • If you are overweight, losing weight can help relieve gout.
  • Take an anti-inflammatory medication as soon as possible
  • Ice and elevate the joint
  • Drink plenty of fluids (no alcohol or sweet sodas)

Some people with gout also have other health problems, such as heart disease, high blood pressure, kidney disease, or obesity. If you have any of these issues, it’s important to work with your doctor to manage them. This can help improve your overall health and might also help with your gout.

Eating a healthy diet, engaging in regular physical activity and losing weight if needed can lower your risk of repeated gout attacks, as well as the chances of developing heart disease, which is common in people with gout.

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