Gout is a type of arthritis caused by the formation of uric acid crystals in the joint --primarily the big toes--resulting in severe pain and swelling. Affecting approximately 2 million Americans, gout is one of the oldest known diseases that is associated with an overindulgence in food and drink, notes Cedars-Sinai.
Cause
A chemical called uric acid is produced in the body in response to the breakdown of purines, a substance found in rich foods and drinks. The body typically disposes of uric acid by excreting it in the urine, produced by the kidneys. However, under abnormal conditions the body may have difficulty ridding uric acid or it may produce high concentrations of uric acid. When uric acid levels are too high, they form crystals that become lodged in the joints, causing severe pain and swelling, hence gout.
Signs and Symptoms
Signs and symptoms of gout include excruciating pain in one joint, typically the big toe; however, any joint can be affected. The joint will be swollen, purple and immobile. You may experience a fever over 39 degrees celcius with chills. Gout develops quickly, often occurring at night and lasting 5 to 10 days. If the condition becomes chronic, lumps called tophi appear under the skin along the joint margin.
Risk Factors
Gout tends to run in families; therefore, you most likely will experience gout because you have a predisposition for it. Other conditions such as cancer or blood disorders will cause gout as well, but the may risk factors include the ingestion of triglycerides or fat; drinking too much alcohol; and eating foods high in purines such as meat, organ meats, shellfish and alcohol, according to the University of Maryland Medical Center.
Diagnosis
A physician will diagnose gout by assessing the affected joint for pain and swelling, testing the blood for a high uric acid level and, on rare occasions, aspirating fluid from the joint space, using a syringe, to assess for the presence of uric acid crystals.
Treatment
Initial treatment begins with controlling the inflammation using over-the-counter non-steroidal anti-inflammatory medications, and hot and cold compresses. On rare occasions, corticosteroids will be injected into the joint to decrease inflammation immediately. To prevent an increase in uric acid levels in the blood, physicians recommend maintaining a healthy weight, eating small amounts of foods with high purine content, getting plenty of sleep, drinking water and avoiding alcoholic beverages. If your blood uric acid level does not normalize, medications such as probenecid or sulfinpyrazone can be used to help the body excrete uric acid through the urine. Tophi will decrease in size as uric acid concentration decreases, but if they remain, surgery may be recommended.
