gout

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What is gout?  

Gout is a condition in which the body produces too much uric acid. Uric acid is produced naturally when the body breaks down old cells and creates new ones. In gout, uric acid comes in the form of crystals that sometimes collect in or around joints. The crystals cause severe joint pain, redness and swelling. .  

Gout occurs in sudden attacks that usually affect a joint.  

The attacks disappear within a few days. 

Some people experience multiple attacks per year. 

 If a patient has many attacks, their joints may be damaged and they may suffer from constant pain. 

Gout is more common in men than in women.  It usually occurs in middle age, but can also affect younger people. 

 To find out whether gout is present, the doctor may use a needle to remove fluid from the joint for examination. 

Doctors treat gout attacks with medication to reduce pain and swelling. 

 If a patient has frequent seizures, they may need medication to  prevent them.  

What causes gout?  

Gout is caused by high levels of uric acid in the blood. Very high levels of uric acid can form microscopic crystals that accumulate in the joints or under the skin (tophi). The accumulation of crystals causes swelling and pain and may lead to joint damage.  

A person is more likely to develop gout in the following cases: 

He has a first-degree relative who suffers from gout, as this disease runs in families 

Has kidney problems, such as kidney disease 

He drinks a lot of alcohol 

Eats a lot of certain foods that increase uric acid levels, such as livers, kidneys, herring, mussels, sardines, asparagus, and mushrooms 

Takes certain medications 

Has lead poisoning (when lead builds up in the body) 

Is overweight or obese 

Has metabolic syndrome (a condition that can cause a large waist, high blood pressure, and high blood sugar levels) 

Undergoing chemotherapy or radiation therapy for cancer 

When you have gout, an injury, illness or surgery can trigger attacks. 

 What are the symptoms of gout?  

The patient will usually experience sudden and severe pain in the joint, 

The joint becomes: 

Warm 

red 

Swollen 

Other symptoms may also appear, such as: 

Fever 

Feeling unwell 

The first attack usually affects only the big toe, but other joints may also sometimes be affected, such as: 

Joints in the foot and the big toe 

ankle 

knee 

Wrist 

Attached 

Even without treatment, symptoms will go away slowly and will not reappear until the next gout attack. 

 Treatment will help symptoms go away more quickly and may also help prevent more severe attacks that affect more than one joint and last up to 3 weeks. 

 Over time, joint stiffness or damage may occur. Hard lumps (tophi) can form under the skin around joints. Certain medications can help prevent or treat lumps. 

 Kidney stones can also occur in about 1 in 5 people with gout, and cause pain and kidney problems. 

 How do doctors know if a person has gout? 

 Doctors suspect gout based on symptoms and examination results.  

To confirm the diagnosis, they will do tests, such as: 

Taking a small amount of fluid from the joint (joint aspiration), where they will examine the fluid under a special microscope to look for uric acid crystals 

X-rays of the joint to check for bone changes that are common with gout 

Ultrasound to detect uric acid crystals within the joint 

Doctors may also do a blood test to check the level of uric acid, but the level may not be high even though gout is present. 

 How do doctors treat gout?  

Doctors may do the following: 

Giving the patient tablets to relieve pain and swelling 

In rare cases, medication is injected into the joint 

They ask the patient to use a splint 

They ask the patient to rest the joint, and they apply ice to the joint for twenty minutes every few hours 

If the patient is at risk of developing uric acid kidney stones, ask him to drink 3 liters or more of fluid each day (about 12 8-ounce glasses of water). 

 If a patient has uric acid stones in the urinary tract, doctors sometimes use sound waves to break up the stones so they can be passed into the urine. 

 If a person has large lumps (tongues) around the joints that do not go away with treatment, doctors may use surgery to remove them. 

 How can gout attacks be prevented?  

To prevent future gout attacks, doctors will ask the patient to: 

Do not drink alcohol 

Reduce his body weight 

Stop taking medication that increases uric acid levels 

Reduce the intake of foods that increase uric acid levels 

Sometimes, doctors will ask the patient to take medication daily to lower the level of uric acid in the blood.