What is gouty arthritis?
Gout is a type of arthritis that occurs when there is a built-up of uric acid in the blood, which is deposited as crystals into the joints and/or soft tissues surrounding them. These crystals cause inflammatory arthritis, which leads to swelling, redness and a lot of pain in the joint. In many people, gout initially affects the big toe (a condition also called podagra).
What are the symptoms of gout?
A gout attack can occur quickly and suddenly, and often overnight. There is usually intense redness and swelling of the joint, which is extremely painful even to the slightest touch. This type of arthritis usually affects one joint at the time and the big toe is often involved.
What causes gout?
Gout is caused by the built-up of uric acid in the blood when the kidneys do not excrete it quickly enough. However, there are factors that may increase the risk of gout, which include:
- Medical history – Gout is more common in elderly people who take diuretics or/and have kidney disease.
- Sex and age – Men aged between 40 and 50 are three to four times more likely to be affected by this disease.
- Weight – Obesity and overeating.
- Hereditary factors – Family history of the disease.
- Nutrition – increased dietary intake of purines (e.g. herring, tuna, anchovies, liver and sweetbreads, sugary drinks).
- Alcohol – Excessive consumption of alcohol, especially beer.
How is gout diagnosed?
Gout may be difficult to diagnose because the symptoms can be vague and it often mimics other conditions. Apart from questions regarding your symptoms, diet and medical history, the following tests might be needed to either confirm or rule out the diagnosis of gout:
- Joint fluid test. Fluid drawn from the affected joint will be examined under a microscope to check if there are uric acid crystals present.
- Blood and urine tests, which measure the levels of uric acid in your blood and urine.
How is gout treated?
If you have been diagnosed with gout, your treatment will aim in symptom relief first.
The following medications are often used:
- Non-steroidal anti-inflammatory drugs (NSAIDs): Type of painkillers usually recommended as initial treatment for gout. They reduce levels of pain and inflammation.
- Colchicine: Alternative choice for people who do not tolerate NSAIDs.
- Corticosteroids: These are used as treatment in severe cases of gout (pills or injections) in people who do not respond to or are not able to take NSAIDs or colchicine.
What can I do to avoid another attack of gout?
There are several ways to prevent gout, such as:
- Medication (e.g. Allopurinol), prescribed by your doctor.
- Balanced diet that does not exceed the permitted amounts of foods with purines (e.g. herring, tuna, anchovies, liver and sweetbreads, sugary drinks).
- Weight loss and minimum consumption of alcoholic beverages.
Note: Pseudogout is often confused with gout because it produces similar symptoms. It is a separate condition from gout and may require different treatment.