What is Gout

Gout is a form of arthritis that causes sudden, severe episodes of pain, tenderness, redness, warmth and swelling of joints.

  • The most common joint that is affected by gout is the large big toe( other – Ankle and Knee).
  • Gout pain and swelling is caused by increased levels of uric acid in the blood and the formation of uric acid crystals in joints.
  • Uric Acid is a substance that normally forms when the body breaks down waste products called purines.
  • Gout usually occur in 3 Phases :
  1. Sudden joint pain and swelling that usually goes away after 5 to 10 days.
  2. A period of no symptoms at all, followed by new, sudden attacks of gout.
  3. After a number of years, if left untreated, persistent swelling, stiffness and mild to moderate pain in one or more joints can occur. Joint destruction with permanent disability can happen. In addition, crystals of uric acid can form large deposits under the skin called tophi.

Causes of Gout:

  • People who have gout have high levels of uric acid in their blood. This is called hyperuricemia. However, there are many people who have hyperuricemia but not gout.
  • Hyperuricemia occurs when the kidneys can’t get rid of uric acid fast enough or the body makes too much uric acid. Using certain diuretic medications or “Water Pills” can cause hyperuricemia. Diuretics are used to get rid of extra body fluid and to lower high blood pressure. But all diuretics, as well as several other medications can lower the kidneys ability to remove uric acid, which raises uric acid levels in the blood.

7 ways to prevent Gout:

  1.  Gout can be controlled and even prevented if it s diagnosed correctly, appropriate medication is taken, and diet and lifestyle changes. It is important to see a Rheumatologist, a doctor who specializes in arthritis and related conditions such as gout.
  2. Medication to treat acute pain : Medications can help relieve the pain and swelling of an acute episode, prevent or treat tophi, and prevent uric acid kidney stones. The amount of medication you take will depend on your symptoms and laboratory test results. You may only need to take one medication. On the other hand, it may be necessary to take a combination of medications.
    Ex: NSAIDs Indomethacin, Ibuprofen and Naproxen sodium, Corticosteroids (Prednisolone) and Colchicine.
  3. Medications that Control Uric Acid Levels: Allopurinol , Febuxostat , Probenecid. These medications do not relieve the pain and inflammation of an acute attack. They are usually started after the acute attack of gone has been treated. Uric acid levels can begin to drop within 1 or 2 weeks of starting one of these medications.
  4. Diet: Obesity is linked to high uric acid levels in the blood. Moderation in the size of food portions is essential. Drink plenty of nonalcoholic fluids, especially water, to help eliminate uric acid.
  5. Less Intake of food having Purines:
    (a) High Purine Concentration (150 to 1000mg of purine /100g): liver, Sweetbreads, Brains, Fish roe/eggs, Beer, Kidney, Sardines, Gravies, Broths, Mussels, Wine, Anchovies, Heart, Herring (Doctor may recommend not eating these foods)
    (b) Moderate Purine (50 to 150mg/100g): Meats, Peas, cauliflower, Lentils, Yeast, Beans, Asparagus, Mushrooms, Spinach, Whole grain cereals, Fowl( chicken or duck) and other sea food.(Doctor may recommend that you not eat more than one serving of any of these foods)
    (c) Mild: Vegetables( except for those listed above), fruits, Milk, Eggs, Spices and Condiments including salt & vinegar, Refined cereals & products, Butter & fats, Sugar & sweets, vegetable soups( Clear broth), Nuts.( No Limit)
  6. Physical Activity and weight Control
  7. Gout may be associated with High blood pressure, obesity,Diabetes mellitus or kidney diseases so your doctor will check for problems and treat them if they occur