What is gout?
Gout is caused by the deposition of uric acid salts in the joints. Uric acid is produced during normal metabolic processes, and in the majority of patients the problem arises because uric acid is not excreted in sufficient quantities by the kidneys. Gout most frequently affects chronic kidney disease patients, obese patients, alcoholics, and patients suffering from psoriasis.
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Gout treatment
What are the symptoms of gout?
A gout attack starts suddenly. Patients are woken by severe pain, which in 90% of cases occurs at the base of the big toe. The pain is accompanied by swelling and redness of the joint. Even if left untreated, an acute gout attack subsides within a few days. As the disease progresses, attacks become more frequent, and swelling of other joints then begins to appear. Ultimately, untreated patients develop chronic gout, which involves persistent inflammation of multiple joints and skin tophi—deposits of uric acid that periodically ooze a chalk-like substance.
How is gout diagnosed?
The diagnosis of gout is made by rheumatologist following an appropriate examination. The measurement of uric acid in the blood, as well as other parameters, is of great importance for establishing a diagnosis. However, for a definitive diagnosis of gout, the most reliable method is to analyse the fluid from the inflamed joint. If uric acid salt crystals are present in the fluid, this is definitive proof that the patient has gout. Ultrasound examination can be of great importance for the diagnosis of gout, especially when the gout is in its early stage and affects a joint from which fluid cannot be obtained for analysis.
How is gout treated?
An acute gout attack is most commonly treated with non-steroidal anti-inflammatory drugs. The drug colchicine is also registered worldwide, and corticosteroids can be used as well. After the acute attack subsides, medications that reduce uric acid production, such as allopurinol and febuxostat, are introduced into the treatment. An important part of the treatment is also an appropriate diet.
How can patients help themselves?
During an acute gout attack, the affected joint should be rested and cold compresses applied. For the long-term management of gout, it is essential to reduce body weight, avoid the consumption of alcoholic beverages, particularly beer, red meat, seafood, and sweetened drinks. Wine is permitted in moderation. Daily consumption of skimmed milk dairy products, which promote the excretion of uric acid, is advised. Drink an adequate amount of fluids and avoid medications that can decrease the excretion of uric acid (consult your doctor).
