Gout

Gout is caused by crystals of uric acid precipitating and settling in joints. When that happens, inflammation occurs in the joint.

Uric acid is a substance that is formed in the liver and spleen. 

Usually, there is a balance between production and excretion of uric acid. In gout, the amount of uric acid is often higher. This can be either due to too much uric acid being produced, or the kidneys not excreting enough. The amount of uric acid can be measured in blood samples.

The risk of gout increases if you:

• drink a lot of alcohol
• consume a lot of food and drink containing fructose
• are overweight
• eat a lot of food that contains large amounts of the substance purine. Purine is found in meat and seafood, for example.

Some people get just one gout attack. But most people get at least a second episode within 12 months. Some have long-term problems with gout, and then several joints can be affected at the same time.

Gout can manifest in multiple ways, but the most common is a recurrent attack of acute inflammatory arthritis (a red, tender, hot, swollen joint). The metatarsal-phalangeal joint at the base of the big toe is affected most often, accounting for half of all cases. Though other joints, such as the heels, knees, wrists, and fingers, may also be affected. Joint pain usually begins during the night and peaks within 24 hours of onset. This is mainly due to lower body temperature. Other symptoms may occur along with the joint pain, including fatigue and a high fever, but this is rare.

Long-standing elevated uric acid levels (hyperuricemia) may result in other symptoms, including hard, painless deposits of uric acid crystals known as tophus. Extensive tophi may lead to chronic arthritis due to bone erosion. Elevated levels of uric acid may also lead to crystals precipitating in the kidneys, resulting in stone formation and subsequent urate nephropathy.

To avoid and prevent gout, you should eat less of foods containing high levels of purine. It is also good to:

• drink milk products with low fat content
• lose weight if you are overweight
• avoid alcohol
• Avoid sweet drinks
• eat healthy food.

If you have gout, you should let the affected joint rest. There are non-prescription drugs, like NSAIDs, in pharmacies. They cause the inflammation to disappear faster.

There are drugs that prevent gout attacks by lowering uric acid levels in the blood. The drugs are given on prescription after individual assessment by a doctor.

The symptoms of gout are quite clear. If you recognize the problems described here, you should seek medical help.

• online consultations with a doctor
• individual assessment and prescriptions for confirmed diagnosis.