Gout

Gout
 

1.       What is gout?

Gout is a type of arthritis. It is caused by uric acid crystals deposited in the spaces between the joints of the feet, hands and some larger joints. The deposition of the uric acid causes inflammation in the joints and the surrounding tissues, resulting in severe pain.

Uric acid is a waste product from the body, especially from the breakdown of proteins called purines. It is often cleared by the kidney and passed in our urine.  When the level of uric acid is high and our kidneys are unable to cope with the high load of uric acid, gout is formed.

 

Almost anyone can get gout.  However, it does appear to be hereditary.  It is far more common in men between ages of 30 and 60 years old.  There are many well-known people who had gout, such as Alexander the Great, Kublai Khan, Michelangelo, Martin Luther, Isaac Newton, Henry VIII, John Wesley, Francis Bacon and Benjamin Franklin.

2.       What are the symptoms?

The main symptom of gout is severe pain, usually in the hands and feet, especially at the base of the big toe.  Sometimes, it can occur at the elbows or knees.  Pain usually comes without warning and often in the early morning.  Then the joints become tender and you may not be able to bear weight.  The inflamed skin over the joint is often red, shiny and dry.  The first episode of gout flare up usually lasts for a period from a few hours to about 2-3 days, depending on how soon you begin treatment.

3.       What brings on gout?

Over-indulgence in rich foods and alcohol can bring on an acute attack of gout in people who are prone to have gout.  Gout is also associated with obesity and high blood pressure.  Some medications, such as fluid tablets, injury, surgery or starvation can bring on gout.  Gout is a curable disease, however, if it is left untreated, it can cause kidney stones, kidney failure and, in rare cases, death.

4.       What is the treatment?

a.      The treatment for the acute gout attack:

The earlier you get on with treatment for an acute attack of gout, the better the outcome will be.  You should see your doctor for assessment and advice on treatment. There are some medications available for any acute gout flare up.  Analgesic medications can also be used for the severe pain in gout.  You should also have plenty of fluid, especially water.  Bed rest is important. Some relief can be obtained by using a heat pack or ice pack over the affected joints. Keeping the weight of the bedclothes off your feet can also help relief pain.

People with many frequent recurrent episodes of acute gout flare up may need some prophylaxis medication for gout to prevent it from recurrent flare ups. You should consult your doctor for further advice.

b.      Rules of moderation:

·         Restrict intake of foods high in purines, such as organ meats (liver,
    brain, kidneys, and sweetbread), shellfish and tinned fish such as sardine,
    anchovies and herrings.

·         Reduce your alcohol intake to two standard drinks a day.

·         Eat a normal, healthy and balanced diet.

·         Drink plenty of water.

·         Maintain normal and healthy weight.

·         Get regular exercise.

·         Wear comfortable shoes.

·         Avoid strenuous exercise.

·         Avoid exposure yourself to cold.