What is Gout

Gout is a result of prolonged, untreated and high uric acid level in the bloodstream. The condition is also referred to as the 'Disease of Kings' or the 'Rich Man's Disease'. The epithets are the result of research that reveals gout to be part and parcel of affluent societies, rich in protein and fat diet and alcohol. However, it is not rare to observe the condition among the poorer classes, who indulge in regular alcohol abuse, worsened by insufficient food intake. The onslaught of gout is characterized by an excruciating joint pain. The pain is usually unexpected and accompanied by swelling, stiffness and soreness.

The condition is most observed in the toes of men, but also affects women and other body parts or joints as well. It is accompanied by fever, intense joint pain and inflammation of the tissues, in and around the affected joint. Gout attacks the big toe, heel, ankle, instep, wrist, knee, fingers, elbow and/or the spine. There have been cases where the condition has arisen out of immobility caused to joints due to a previous injury. Similarly, hyperuricemia patients also develop tophi or uric acid crystal deposits in tissues such as observed in the helix of the ear. Elevated levels of uric acid in the urine is indicative of the accumulation of uric acid crystals in the kidneys or bladder. If left untreated, the condition could culminate in uric acid kidney stones.

What Causes Gout?

Gout is a medical condition that arises when crystals of uric acid precipitate on the articular cartilages of body joints. The accumulation is also observed on tendons and surrounding tissue. Blood serum comprises uric acid as a vital component; however, in the case of hyperuricemia or hypouricemia, the elevated or lower levels of uric acid leads to the onslaught of gout. The precipitation of uric acid is also observed in the case of low blood pH, a condition medically referred to as acidosis. Purine metabolism causes the natural excretion of uric acid in the urine. During the course of a normal cellular turnover, purines are generated. They can also be ingested as part of the daily diet. It helps a lot to incorporate low purine diet tips while generating a diet plan to treat gout.

In the case of primary gout, the high levels of uric acid in the blood, that is the result of the intake of protein-rich foods that cause gout, alcohol and/or hereditary factors causes obesity and exposure to an increased risk of diabetes, hypertension and heart disease. Primary gout is also observed as the outcome of health conditions such as those that arise out of lead poisoning and renal failure. On the other hand, secondary gout is a complication that arises from other medical conditions like metabolic syndrome and blood cancer or leukemia. Gout has been identified as a comorbidity condition of polycythaemia, renal disorder, obesity, diabetes, high blood pressure and hemolytic anemia. Gout also arises out of organ transplant.

The diagnosis of the condition involves microscopic analysis of uric acid crystals, aspiration of synovial fluid, haemogram to define blood count, thyroid function tests, analysis of the erythrocyte sedimentation rate and/or ultrasound imaging. The gout treatment options adopted are primarily to manage symptoms, prevent severe attacks and lower the serum uric acid level. Nonsteroidal anti-inflammatory drugs(NSAID), colchicine and glucocorticoids and joint injections help to manage symptoms of gout. In order to prevent the onset of acute attacks or reduce the severity of prevalent joint pain attacks diclofenac, etoricoxib, ketoprofen and/or sulindac and similar NSAIDs are prescribed. The onset of gout can be effectively prevented with the help of medication, a low-fat and low-protein diet plan, reduced intake of purines and heat therapy. The condition is treated with the help of drugs such as xanthine oxidase inhibitors and uricosurics and/or total parenteral nutrition within a dedicated gout diet.

Gout has lived up to its reputation for being the 'Rich Man's Disease' by enlisting famous sufferers such as Nostradamus, Sir Isaac Newton, Thomas Jefferson, Benjamin Franklin and Mel Brooks.