Hyperuricemia is one common metabolic illness causing sudden and severe pain, swelling, stiffness and inflammation of small joints (Hand and Feet) due to increased uric acid in blood , causing it to deposit in joints as crystals. 

Classic Presentation is of Great Toe Pain and Swelling called Podagra, often it is the only sign of raised blood uric acid levels. 

Gout represents acute situation of Pain, Redness and Swelling especially of Small joints and rarely joint like shoulder, knee etc. 

Tophi are stone like accumulations that form in large joints like Knee, Shoulder that form when there is persistant high uric acid  levels (16-20mg/dL) in body over a longer period of time. They often cause pain, block normal joint movements, often need surgical removal. 

Uric Acid lowering medications essentially Increase uric acid excretion (Uricosuric) or Reduce Uric Acid Production ( Uricostatic). Either one is prescribed depending on doctors preference and patients response.

Rest medications are symptomatic anti-inflammatory and pain killers. Colchicine a potent anti-inflammatory agent is specifically given in Gout, uric acid lowering medications are with held till acute period passes. 

Dietary factors can also play an important role by stabilizing levels of uric acid in blood which can reduce the risk of gout attack.

Certain food items that should be avoided in people known to or prone to have hyperuricemia are:

  •  Tomato
  • Yellow Pulses ( Chana, Moong and Arhar Dal) 
  • Green Leady Vegetables ( Palak, Methi etc). 
  • Soyabeen
  • Brinjal
  • Sugary beverages ( Fruit juices, Sodas) 
  • Red Meat 
  • Alcohol (Beer)

Some lifestyle modifications include: 

  • Drink plenty of water (helps in flushing out uric acid faster)
  • Try reaching the ideal body fat percentage i.e. lose weight.
  • Eat fresh fruit , vegetable , wheat products.
  • Have low fat milk and dairy products. 
  • Avoid high purine content of food. 

Important Tips:

  • Whenever any one experiences a Gout attack; Apply Ice packs, get uric acid levels tested and seek medical opinion.
  • Once the uric acid levels cross normal value, diet restrictions along become ineffective, thus medicines along are needed to brink back Uric acid levels to nromal.
  • Uric acid medication are almost to be taken long time say lifetime. Once cannot Predict when you need to stop, blood values are best , weaning off the medicines should be under medical supervision. 
  • Repeat uric acid levels monthly, keep a record of the uric acid levels.
  • Raised uric acid levels may run in families (hereditary) so one should be updated about uric acid status, especially when facing small joint pain or stiffness.