Gout is a disease that may be linked to one's diet, genetics, drug intake, kidney function and other factors. This disease is a common cause of arthritis.
Gout is a disease caused by a surplus of uric acid within the body. Within this condition the joints may become inflamed when crystals of sodium salt from uric acid are deposited in the joints. The condition most commonly affects the metatarso-phalangeal joint, the mid-tarsal joints and the knees.
Gout has a prevalence of 5–28 of every 1000 persons for males, and 1–6 of every 1000 persons for females As a result, gout is the leading cause of inflammatory arthritis in men forty years old and over.
Middle-aged Men and Gout Risks
- A family history of gout
- Obesity
- High alcohol intake
- Hypertension
- Hypertriglyceridemia
- A family history of cardiovascular disease
Gout may be caused by hyperuricaemia in some cases. This results from the inability of the kidney to excrete adequate amounts of uric acid into urine. This inability may be linked to heredity or also to the use of diuretic drugs like alcohol, which may reduce the renal excretion of uric acid.
Ironically, gout was satirically referred to as the disease of kings and the king of diseases. In the past it gained notoriety for causing painful and debilitating arthritis. The term gout is derived from the Latin word gutta which means a drop. In the 13th century it was believed that gout resulted from a drop of evil humor which affected vulnerable joints.
Events that May Trigger Gout Attacks
- Alcohol ingestion
- Hemorrhage
- Dietary excess of purines (high protein diets)
- Acute medical conditions including infections
- Exercise
- Trauma
- Drugs
- Radiation therapy
- Surgery (during postoperative period 3–5 days)
Gouty Arthritis has Four Stages
- Asymptomatic hyperuricemia: elevated serum uric acid level without gouty arthritis, tophi or uric acid nephrolithiasis
- Acute gouty arthritis
- Inter-critical gout: intervals between acute attacks of gout without symptoms
- Chronic tophaceous gout: development of subcutaneous, synovial or subchondral bone deposits of monosodium urate crystals
Symptoms of Acute Gout Attack
- Acute attacks begin abruptly during night or early morning
- The affected joint becomes painful, warm, red and swollen
- A low-grade fever may be also present
- Early attacks may be resolved between 3 to 10 days
Gout Treatment
Acute attacks are treated with anti-inflammatory medication, typically a decrescendo regimen of NSAIDs. If NSAIDs are resisted, a dose of steroid of about 40 mg may be administered orally or intramuscularly. If the affected joint is not infected, it is safe to inject steroids into the joint to tackle the inflamation. Steroid injections must be kept to a maximum of about four per year.
Low doses of colchicine may also be taken twice a day. It is important for the patient to manage obesity and alcohol intake, and to discontinue the usage of drugs like salicylates or diuretics.
Dieting for Gout Patients
Patients should avoid:
- Meats, particularly organ meats such as liver and kidney
- Seafood, particularly shellfish, sardines, anchovies
- Vegetables and legumes: asparagus, cauliflower, spinnach, beans, peas and mushrooms.
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