Gout is a form of arthritis that occurs when uric acid builds up in the joints, causing recurring attacks of inflammation and pain. According to MayoClinic.com, gout usually affects the joint of the big toe, but it can occur in the feet, ankles, knees and hands. Most patients with gout will experience repeated attacks.
Symptoms
The most common complaints of patients with gout are severe joint pain, swelling with redness, and warmth that evolves rapidly over hours to days, according to "Clinical Practice of Emergency Medicine." The area of swelling can be so tender and painful that even having a light sheet touching the area is unbearable for the patient. Gout attacks usually subside within hours to days either with or without medications. In rare instances, the attack may last for weeks.
Causes
"Orthopedic Nursing" indicates that gout was once believed to be a disease of the rich and famous caused by consuming rich foods and fine wines. Diet and alcohol may contribute to gout, but they are not the main cause. When excess uric acid is formed in the body and the kidneys are unable to filter it, the uric acid builds up and causes urate crystals to accumulate around joints.
Frequency of Attacks
Once a person has had one gout attack, there is a good chance it will happen again, but predicting when and how often is difficult. The incidence of recurrence may have identifiable reasons, such as medications and diet, that can be modified to help prevent the frequency of recurrence.
Identification
The identification of gout by the physician is usually based on the patient's history and physical examination of the affected joint. During an acute attack, joint fluid can be obtained with a needle and sent to the laboratory to check for urate crystals. This is the most accurate test to confirm gout.
Treatment
Treatment for gout usually requires medications, which will be determined by a physician based on the patient's overall health status. Commonly prescribed medications include nonsteroidal anti-inflammatory drugs, or NSAIDs, which will help decrease inflammation and control mild to moderate pain. If patients are unable to take NSAIDs, steroids may also be used to help control inflammation and pain. Steroids can be taken by mouth or injected into the joint area. Medications to help block the production or improve the excretion of uric acid may also be ordered.
Diet
In addition to medications, there are dietary changes that can help treat the symptoms of gout. Diet recommendations include increasing fluid and water intake daily and avoiding alcohol. Patients with gout may be instructed to eat a moderate amount of protein and limit daily intake of meat, fish and poultry.
References
- "Orthopedic Nursing"; Gout: Not Just for the Rich and Famous; Mary Kamienski; Jan/Feb 2003
- "Clinical Practice of Emergency Medicine"; Lippincott Willams & Wilkins; 2010
- MayoClinic.com: Gout
