Gout Symptoms And Treatment by Jane Thurnell-Read

Gout is an ancient and common form of inflammatory arthritis, and is the most common inflammatory arthritis among men. Unlike most types of arthritis, which are more-or-less present all the time, gout often occurs as painful flares lasting days/weeks followed by long periods without symptoms. 

A gout flare-up is characterized by pain, redness, swelling, and warmth lasting days to weeks in the affected joint or joints.

What Causes Gout? 

Gout is a chronic disease caused by an uncontrolled metabolic disorder, hyperuricemia, which leads to the depositing of monosodium urate crystals in tissue. Hyperuricemia means too much uric acid in the blood. Uric acid is a metabolic product resulting from the metabolism of purines (found in many foods and in human tissue).
 
Hyperuricemia is caused by an imbalance in the production and excretion of urate, a body waste product. This can be caused by over-production of urate, or because the body does not effectively excrete enough of it. Sometimes both over-production and under-excretion are present.  Under-excretion is the most common cause, thought to account for 80–90% of hyperuricemia. -
 
Hyperuricemia is not the same as gout. Some people have hyperuricemia but do not have gout. Current medical thinking is that treatment is not necessary when this is the case.

Risk factors for gout include being overweight or obese, having hypertension (high blood pressure), alcohol intake (beer and spirits more than wine), diuretic use, and a diet rich in meat and seafood. Losing weight has been shown to lower the risk for gout.

What Are The Symptoms Of Gout?

Gout can be viewed in four stages:

• Hyperuricemia  present but there are no symptoms.  Urates are being deposited into the tissues and causing damage.
• Acute flare-ups occur when urate crystals in the joint or joints cause acute inflammation. Symproms of a gout flare- Pain may be mild or excruciating. Most initial attacks occur in the legs and feet, most commonly the metatarsophalageal joint of the big toe. Uric acid levels may be normal in about half of the people with an acute flare-up of gout. Elderly people with gout are often affected in many different joints.
• Inter-critical segments occur after an acute flare has subsided, and a person may enter a stage with clinically inactive disease before the next flare. The person with gout continues to have hyperuricemia, which results in continued deposition of urate crystals in tissues and resulting damage. Inter-critical segments become shorter as the disease progresses.
• In chronic soreness and aching of joints is present all the time. People with gout may also get tophi (masses of urate crystals deposited in soft tissue)—usually in cooler areas of the body (e.g., elbows, ears, distal finger joints).
   
  Gout is also associated with an increased risk of kidney stones. 

Treatment Of Gout

Medical treatment for gout consists of non-steroidal anti-inflammatory drugs, steroids, and colchicine.

Diet and lifestyle changes may help prevent attacks:

• Weight loss
• Avoiding alcohol
• Reducing dietary purine intake (e.g. caffeine, anchovies, sardines, organ meats, pulses and yeast extract).
• Reducing/avoiding refined carbohydrate (such as white bread, white pasta etc.) and sugar.
• Increase water intake to prevent crystal build-up in the kidneys.
• Supplements may help : anthocyanidins may help reduce uric acid levels in the body. Vitamin E and vitamin C may also help. Artichoke supplement and quercetin help some gout sufferers too.
• Changing medications (e.g., stopping diuretics) associated with hyperuricemia may also help. Consult your medical practitioner about this.