Gout
is a condition in which there is an excessive accumulation in
the body of uric acid and its salts, urates. It is found, most
frequently, in men, rarely in children unless other illnesses
are involved. There is quite a strong family tendency. In gout,
urates are deposited at various parts of the body, particularly
around joints, crystallise out and cause much pain and inflammation.
Urates can also accumulate in the skin and kidneys (see Kidney
Stones). The classic attack of gout is an acute inflammation
of a joint particularly at the base of the big toe. The joint
becomes inflamed, swollen, exquisitely tender and painful to
move. Similarly, acute gouty arthritis may occur in other parts
of the foot, and typically in the wrists and hands. An attack
can last some days and repeated attacks can damage a joint permanently
(see Osteoarthritis). Gout can damage the kidneys and the urate
stones that result can cause great pain. Accumulations of uric
acid and urates can be found in the skin and cartilage. Known
as "tophi" they are most commonly found in the ear. Gout is diagnosable by its typical clinical appearance and a blood test which will show an abnormally high amount of urate in the blood. Some people get an acute arthritis very much like gout in appearance but with normal blood levels of urate and uric acid. This is not gout and is known as "pseudo-gout". Although the tendency to have gout is part of some people's bodily makeup (the presence or absence of certain enzymes etc,) there are other factors that bring gout on., particularly an excessive intake of alcohol. Excess consumption of certain foods may also contribute to the process as will medications such as diuretics. The treatment of some severe conditions, such as leukaemia, can lead to rise in urate levels and subsequent gout, even in children.
In those with a past history of gout, or a family tendency towards the disease, excess alcohol should be avoided. Doctors manage gout in two ways, the acute attack and the long term. The usual treatment of an acute attack of gouty arthritis is an NSAID ( non-steroidal anti-inflammatory drug) in high dosage. Colchicine, a traditional remedy, is still used in certain circumstances. The classic long-term treatment of gout is allopurinol, a medication that slows down the formation of urates in the body. Sometimes drugs, urosurics, are used that increase the excretion of urates in the urine. Monitoring of blood pressure should be carried out on all gout sufferers. |
