Gout is a very painful form of arthritis, an inflammation that affects the joints and tendons as well as other tissues. Gout usually affects one joint at a time and in about 70 per cent of cases the big toe is affected. It can also affect the leg, knee, ankle, foot, hand, wrist or elbow. The finger is occasionally affected, the spine very rarely.
Causes of Gout
Gout is caused by excessive levels of uric acid in the blood. Uric acid, produced during the breakdown of proteins, is usually excreted by the kidneys in urine. When the body cannot get rid of the excess uric acid in this way it collects in the form of monosodium urate crystals. These crystals collect around the joints, tendons and tissues causing the inflammation and extreme pain.
Men and Gout
Gout affects mostly men over the age 45 years. Overweight, frequent alcohol intake and people who take diuretic medicine can be contributory factors. Women who get gout tend to be post-menopausal.
Signs and Symptoms of Gout
The affected area becomes red, swollen, inflamed and extremely painful. Urine output is less than normal and concentrated in color. In its acute form the attack usually lasts between four and ten days. Chronic gout, recurring usually at the site of the initial attack, can later involve other joints and areas. Without treatment the crystal deposits build up causing arthritis, damage in the kidneys, liver, arteries and the heart.
Treatments for Gout
Treatment depends on whether the gout is an acute attack, or control of long-term chronic condition.
NAIDS, Non Steroid Anti-inflammatory Drugs, are used to reduce swelling and help with pain. Corticosteroids can be used if NSAIDs are not tolerated well. Colchicine is occasionally used and is helpful for people with heart problems.
Frequent reoccurrences of acute gout may require long-term interval treatments such as allopurinol (a xanthine-oxidase inhibitor) to reduce the formation of uric acid or uricosuric drugs such as probenecid prescribed to increase excretion of uric acid. These drugs should never be started during an acute attack but can be used indefinitely. If an acute attack develops during the treatment the drugs should be continued.
Famous people affected by Gout
Famous sufferers of gout include Thomas Jefferson (President USA), King Henry VIII of England, Samuel Johnson (writer), Alfred Lord Tennyson (poet) and Benjamin Franklin.