Gout

According to Wikipedia, gout is a form of inflammatory arthritis characterized by recurrent attacks of red, tender, hot and swollen joint. Pain typically comes on rapidly in less than twelve hours. The joint at the base of the big toe is affected in about half of the cases. It may also result in tophi, kidney stones, or uratenephropathy. Gout is due to elevated levels of uric acid in the blood. This occurs due to a combination of diet and genetic factors. At high levels, uric acid crystallizes and the crystals deposit in joints, tendons and surrounding tissues, resulting in an attack of the gout. Gout occurs more commonly in those who eat a lot of meat, drink a lot of beer, or are overweight. Diagnosis of gout may be confirmed by seeing the crystals in joint fluid or tophus. Blood uric acid levels may be normal during an attack.

Uric acid is usually harmless and is made in the body. Most is passed out with urine and some from the gut with the stools (faeces). In people with gout the amount of uric acid in the blood builds up. From time to time the level may become too high and tiny grit-like crystals of uric acid may form. The crystals typically collect in a joint. The crystals irritate the tissues in the joint to cause inflammation, swelling and pain– gout attack.

Uric acid builds up in some cases due to:

  • Not enough vitamin c in your diet
  • Drinking sugar sweetened soft drinks high in fructose which can cause uric acid build up
  • Eating a lot of herring, yeast extracts, sardines or mussels may increase the level of uric acid.
  • Certain medications may also raise uric acid levels, these include bendroflumethiazide, aspirin, diuretics and chemotherapy medicines.

Symptoms of gout include night-time attacks of swelling, tenderness, redness, and sharp pain in your big toe. You can also get gout attacks in your foot, ankle, or knees, or other joints, limited movement in the affected joint, peeling and itching of the skin around the affected joint as the gout gets better, very red or purplish skin around the affected joint. The attacks can last a few days or many weeks before the pain goes away. Another attack may not happen for months or years.

How can gout attack be treated?

  • An ice pack or peas wrapped in a towel to avoid direct skin contact, can be placed upon affected area
  • Anti-inflammatory painkillers will quickly ease most gout attacks within 12-24 hours. There are several types of brands, such as diclofenac, indomethacin and naproxen.
  • Canakinumab is another option that has been recently introduced
  • Colchicine is an alternative medication that eases gout attacks. It is a substitute for patients who have side-effects from anti-inflammatory painkillers. Steroid injections or tablets are other options.
  • Allopurinol is a commonly used medication to prevent gout attacks.
  • Vitamin c supplements is also an option.

Healthy lifestyle suggestions that can help prevent gout attacks

  • Avoid dehydration by drinking plenty of water up to two litres per day.
  • Cut down or preferably cut off sugar sweetened drinks, especially those containing fructose
  • Have your blood pressure checked at least once a year.
  • If you drink a lot of alcohol then it may help if you reduced the amount that you drink. Avoid binge drinking.
  • If you are overweight, try to lose some weight. This can help to lower the uric acid level. However, do not use diets that increase uric acid levels, such as high protein diets or starvation diets.
  • Healthy or sensible eating. Foods rich in purines, such as sea food, livers and kidneys should be cut down drastically.

 

By Umaru Maryam Hadejia

 

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