CAUSES, SYMPTOMS AND TREATMENT OF GOUT

What is Gout?

Gout is a kind of arthritis caused by a buildup of uric acid crystals in the joints. Uric acid is a breakdown product of purines that are part of many foods we eat. An abnormality in handling uric acid and crystallization of these compounds in joints can cause attacks of painful arthritis, kidney stones, and blockage of the kidney filtering tubules with uric acid crystals, leading to kidney failure. Gout has the unique distinction of being one of the most frequently recorded medical illnesses throughout history. Gout is more common in men than in women and more prevalent in African-American men than white men. The chances of having gout rises with age, with a peak age of 75. In women, gout attacks usually occur after menopause. About 21% have elevated blood uric acid levels, a condition known as hyperuricemia. However, only a small portion of those with hyperuricemia will actually develop gout. If your parents have gout, then you have a 20% chance of developing it.
 
Risk Factors for Gout
 

Obesity, excessive weight gain, especially in youth, moderate to heavy alcohol intake, high blood pressure, and abnormal kidney function are among the risk factors for developing gout. Certain drugs and diseases can also cause elevated levels of uric acid. Also, there is an increased prevalence of abnormally low thyroid hormone levels (hypothyroidism) in patients with gout.

Symptoms
 
Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness. The small joint at the base of the big toe is the most common site for an attack. Other joints that can be affected include the ankles, knees, wrists, fingers, and elbows. In some people, the acute pain is so intense that even a bed sheet touching the toe causes severe pain. These painful attacks usually subside in hours to days, with or without medication. In rare instances, an attack can last for weeks. Most people with gout will experience repeated bouts over the years.
 
Common Sites of Attack
 

The joint at the base of the big toe is the most common site of an acute gout attack. These attacks can recur unless gout is treated. See your doctor even if the pain from gout is gone. Over time, they can harm joints, tendons, and other tissues.

Treatment

Maintaining adequate fluid intake helps prevent acute gout attacks and decreases the risk of kidney stone formation in people with gout. Alcohol is known to have diuretic effects that can contribute to dehydration and precipitate acute gout attacks. Alcohol can also affect uric acid metabolism and cause hyperuricemia. It causes gout by slowing down the excretion of uric acid from the kidneys as well as by causing dehydration, which precipitates the crystals in the joints.

Certain medications reduce the pain and inflammation of gout attacks, such as anti-inflammatory drugs (ibuprofen and naproxen), colchicine, and corticosteroids. Other medications decrease the level of uric acid in the blood and prevent the deposit of uric acid in joints (gouty arthritis), the kidneys (stones), and in tissue (tophi), helping to prevent further attacks and complications. These drugs include allopurinol, febuxostat, lesinurad, and probenicid.

If you or a loved one believe that you are having a gout attack, contact a chiropodist for advice and to have your feet checked today!

Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.

 

PROFESSIONAL FOOT CLINIC

416-465-8737

Toronto, ON Chiropodist Academy Foot and Orthotic

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