Gout
Weekend Special

Gout

What is gout?

Gout is a type of arthritis that causes sudden joint inflammation, usually in a single joint. Multiple joints can also be affected. This is known as polyarticular gout.

What causes gout?

Gout occurs due to deposition of uric acid crystals in the joints and other parts of the body. When the level of uric acid in the bloodstream increases, it deposits in various tissues leading to arthritis and other problems. The commonest joint affected is the great toe. Causes of an elevated blood uric acid level include genetics, obesity, certain medications such as diuretics and chronic decreased kidney function.

Gout is more seen in obese patients, sedentary people and found more in people who take alcohol or smoke. It is less common in vegetarians, non-drinkers and non-smokers.

Red meat, chicken and fish intake is associated with increased occurrence of Gout. Many patients of Gout have improved after stopping red meat, alcohol and smoking.

What are gout symptoms and signs?

Uric acid crystal deposits in the joint cause inflammation of the joint leading to pain, redness, heat, and swelling. It is more common in males. It is rare in women before menopause. However, after menopause even women can develop Gout.

Serum uric acid can be elevated in patients of Gout. Normally serum uric acid is usually less than 7 mg% in men and 6 mg % in women. It should be remembered that rise in uric acid level is not synonymous with Gout.

It can be diagnosed with ease and treated effectively. When one evaluates a patient of Gout one must look for hypertension, diabetes as these diseases may co-exist. We must also closely look for kidney stones, and do blood urea and serum creatinine levels to monitor kidney function.

Is it possible to prevent gout?

Some of the risk factors for gout are genetic, and those are not preventable. However, many of the risk factors for gout, such as obesity and diet, are controllable. Maintaining a healthy weight and a diet low in refined carbohydrates and low in saturated fat and red meat may prevent gout.

Intake of vegetarian diet and avoiding smoking and alcohol are useful in preventing attacks of Gout.

There are many medicines like Allopurinol, Febuxostat which decrease Uric acid level in blood. These when taken properly help in controlling Gout. It is important to periodically do serum uric acid once treatment has been started. The treatment should be done under medical supervision.

To conclude, it will be apt to say that, it is a metabolic disease which affects joints and other organs. It can be treated effectively and prevented by leading a healthy lifestyle and following dietary precautions.

What are risk factors for gout?

There are many risk factors for gout. Gout is more common after surgery, trauma, and dehydration. Certain medications such as diuretics, which treat high blood pressure, that raise the level of uric acid in the bloodstream are risks for gout.

Dr. (Col) Vishal Marwaha, MD, DNB, MNAMS

Clinical Professor and Head - Rheumatology and Clinical Immunology

Amrita Institute of Medical Sciences, Kochi, Kerala.