Gout is an abnormality of
uric acid metabolism that results in the deposition of sodium urate crystals in
specific areas around the body including:
-
The joints
where it causes arthritis
-
The soft
tissues causing several serious diseases
-
The urinary
tract causing urate stones and possible renal failure.
Uric acid is produced in the
liver when ingested and synthesised proteins are broken down. In a normal
person, the uric acid is excreted in the urine when the kidneys filter it out of
the blood however in someone suffering from gout, the kidneys either stop
filtering the uric acid out or they don’t filter enough and so the levels build
up and small crystals begin to develop.
There are a number of risk
factors that contribute to the chances of a person suffering from an attack of
gout including certain foods high in proteins, high alcohol consumption,
obesity, high blood pressure, certain drugs and severe psoriasis. Kidney
disease, some forms of cancer and abnormalities of the thyroid also regularly
result in the development of gout.
The most common symptoms of
gout are intense pain and swelling in one or more of the joints, in particular
that of the big toe. The joint becomes hot, red, swollen and very tender to the
touch in a course of a few hours and an acute attack can last for a few days if
not treated quickly. Any of the joints can become affected but gout most
commonly attacks the foot, ankle, knee, wrist and elbow joints. If the gout
recurs often then permanent deposits of urate crystals can cause arthritis or
kidney problems depending on the site at which they settle.
Diagnosis of gout is a simple
procedure and normally only involves a blood test to determine if the levels of
uric acid in the blood are elevated. Unfortunately in some cases of acute gout
the serum uric acid level is only slightly above normal and so it may be that a
second confirmatory test is required. Joint fluid microscopy is a technique that
involves drawing a small amount of fluid from the swollen joint using a fine
needle. When this fluid is examined under a microscope, long needle-shaped
crystals of uric acid become visible which are used to confirm the diagnosis.
Gout needs to be diagnosed as
soon as possible so that any future attacks don’t go on to cause permanent
damage to the joints or arthritis. Occasionally the urate crystals form into
kidney stones which can be extremely painful and prolonged and can damage the
tubes running to the bladder as well as the kidneys.
Prevention of further attacks
of gout will depend on the underlying conditions that were responsible for the
primary attack so for example, if the attack was due to over eating and obesity
then the patient will be recommended a low protein diet whereas if it was due to
excessive alcohol consumption then the amount of alcohol consumed on a weekly
basis should be reduced dramatically. Unfortunately a few cases of gout are due
to cancer or kidney failure.
Gout can be a serious
condition if left untreated and can lead to chronic, painful conditions. Any
symptoms associated with the disease should be investigated quickly so as to
rule out the presence of anything more serious.
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