What is gout?

Gout causes episodes or attacks of painful inflammation. It most commonly affects the big toe joint but can affect any joint. Gout usually starts as an acute attack that often comes on overnight. Within 12-24 hours, there is usually causing severe pain and swelling in the joint.

What causes Gout?

The cause of gout is related to the amount of uric acid in your body. Uric acid is normally dissolved in the blood, but when its high, tiny microscopic crystals may be deposited in the joint. These crystals then initiate the acute inflammation which causes the gout.
There are many causes of this and including:

• Drinking too much alcohol which can cause uric acid to build up
• Drinking sugar-sweetened soft drinks high in fructose can cause uric acid to increase
• Certain foods may ‘tip the balance’ to raise your uric acid higher than normal. In particular, eating a lot of heart, herring, sardines, yeast extracts or mussels may increase the level of uric acid. However, eating a normal balanced diet should not have much effect on the uric acid level
• More uric acid is made than usual in illnesses where the cells of the body have a rapid turnover. For example, severe psoriasis and some blood disorders
• Some of the drugs used to treat high blood pressure can precipitate a gouty attack
• Those with kidney disease may also develop high levels of uric acid

Treatment options

The mainstay of gout treatment is reducing the inflammation and trying to reduce uric acid levels:

When an acute attack of gout occurs, anti-inflammatory drugs (NSAID’s) are usually very effective to help gain control of the gout symptoms in the first 12-24 hours (these drugs have no effect at lowering uric acid levels). Ice therapy, rest and elevation of the foot is also very useful.

Over the longer term, if diet changes are not lowering the uric acid levels, drugs can be used to lower the levels (these drugs have no effect during an acute attack). The drugs must be taken on a continuous and long term basis if they are to be effective. Two examples of drugs that may be prescribed for gout are colchicine (which helps to reduce inflammatory reaction) and allopurinol (which blocks uric acid production).

Outcomes

There are a number of thing that you can do to help yourself manage gout:

• Take your medication as instructed by your doctor
• Reduce your weight
• Take dietary advice to lower your intake of purines and increasing your vitamin C levels is reported to help

These measures should greatly reduce the risk of an attack of gout.