WHAT IS GOUT AND HOW TO MANAGE IT

What is Gout?

Gout is a build up of uric acid which can crystallize into joints, especially the 1st metatarsal phalangeal joint (MPJ) of the foot. Uric acid occurs naturally in the human body as a result of the breakdown of purines. Purines enter the body through dietary intake and during the body's own cell turnover. Uric acid is excreted through the kidneys and intestines as humans lack the enzyme uricase which breaks down uric acid. When uric acid levels exceed normal, it may crystallize in the joints. Gout usually occurs in peripheral joints and crystallizes more at lower temperatures. 
 
4 Stages of Gout
There are 4 stages associated with gout and these include:
 
Asymptomatic Hyperuricemia
  • This stage is asymptomatic and patients often do not know that they are at risk for developing gout. 
 
Acute Gout
  • This stage is usually treated by NSAIDs, corticosteroids or colchicine. 
 
Intercritical Periods
  • Some individuals may only experience one attack of gout and remain in the inter critical period for the rest of their lives, other individuals may have recurrent attacks.
 
Chronic Gout
  • This is the stage of recurrent gout attacks - in this situation it is important to visit your GP to be placed on medication such as allopurinol or probenecid. 
 
How to Prevent Gout:
Steps can be taken to prevent gout and these include:


Hydration  

  • Maintaining adequate hydration helps reduce uric acid and maintain joint health and prevent gout attack

Diet

  • Role of diet in prevention of gout: It is important to limit foods with a high purine intake, these include: red meat, meat gravies, shellfish, red wine, alcohol and beer

Physical activity 

  • can help aid in reducing the chances of a gout attack. If a patient feels that an attack is beginning to occur it is important for patients to get off their feet.

 

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