What causes gout?
- Increased levels of uric acid in the blood
- Leads to formation of sodium urate crystals inside and around the joints
- Crystals may spill over from the joint cartilage and cause inflammation of the surrounding tissues
- Crystals may also clump together and continue to grow over time (which are referred to as tophi), ultimately leading to the irreversible damage to the joint
Symptoms of gout
- Sudden, severe pain in the joints usually accompanied by significant swelling and tenderness around the area
- There may also be shiny red skin around the area which may peel.
- The big toe is the most commonly affected joint
- Symptoms usually last up to 10 days
Risk factors for gout
- Eating a diet that is high in red meat and seafood increases uric acid levels
- Drinking alcohol and eating foodstuffs that are rich in fructose also increases uric acid levels
- Obesity - those who are overweight produce more uric acid
- Family history
- Sex - men are more likely to suffer from gout than women
- Trauma to joints
- Medical conditions - including high blood pressure, diabetes and renal disease
- Medications - including diuretics, aspirin, ace inhibitiors
Treatment of gout
- Relieve symptoms of a gout attack using high doses of NSAIDs e.g. diclofenac, etoricoxib, indometacin etc. If NSAIDs are contra-indicated or poorly tolerated then colchicine should be considered. Aspirin should be avoided in gout as it increases uric acid levels in the blood.
- Prevention of gout attacks usually involves allopurinol or febuxostat (only if allopurinol is contra-indicated or poorly tolerated). Allopurinol should not be used for the treatment of an acute attack of gout.