Gout is also called metabolic arthritis because it is a disease that is due to a congenital problem with the metabolism of uric acid. During an attack of gout the urate crystals are deposited in the cartilage of the joints and in particular tendons. This provokes an inflammatory response that results in severe pain and distress.
Gout is the result of an elevated level of uric acid in the blood stream. This uric acid can also result in kidney stones. Sufferers usually also have a low grade fever.
There are two sources of pain from the inflammation. In the first the crystals inside the joint and tendons cause intense pain when the joint is moved. In the second the inflammation around the joint can be sore and tender. Patients experience swelling, redness, warmth and stiffness of the joint.
Gout often attacks portions of the foot and most often the big toe. Other common joints that are affected are the ankle, heel, knee, wrist, fingers and joints of the small toes. Gout will often disappear after three to five days without treatment. However, people may suffer another attack within a couple of weeks, months, years or not again.
Doctors diagnose gout on a clinical basis since there is no one conclusive test. There are tests to confirm the disease. Hyperuricemia is a common feature – elevated plasma urate level - but doesn’t mean the person will develop gout. These levels are within the normal range in up to 2/3 of cases of people who have active gout disease.
Other blood tests which are performed are a full blood count, electrolyte, renal function panel and erythrocyte sedimentation rate (ESR). These serve mainly to exclude other causes of arthritis. A definitive diagnosis can be made from aspirated fluid from the joint but this may be difficult to perform and painful for the patient. The goal is to identify urate crystals under light microscopy.
Data reported in Clinical Therapy 2003 suggest that environmental, racial and hereditary factors influence the development of gout. The incidence of gout appears to be on the rise worldwide.
Therapies that are widely used include corticotropin and corticosteroids and NSAID’s (Non-steroidal anti-inflammatory drugs). In Clinical Therapy the researchers also determined that urate lowering therapy and prophyactic colchicine are successful when used for long-term prophylaxis.
Gout carries a significant economic burden – approximately 27 million in U.S dollars annually are spent to treat gout and in the workplace in lost wages.
Dietary alterations are recommended to prevent new outbreaks of gout. The recommendations are to avoid foods that are rich in purine and avoid a high protein diet. Foods that are rich in purine are hearts, herring, mussels, yeast, smelt, sardines, and sweetbreads. Other foods are moderately high in purine and include anchovies, grouse, mutton, veal, bacon, liver, salmon, turkey, kidneys, partridge, trout, goose, haddock, pheasant and scallops.
Making dietary changes to your daily routine are easy. Before you make any other changes to your routines consult your physician. You may unknowingly change something that will affect another of your medical conditions and the results you seek will not be effected.
Gout is self-limiting but can be persistent. With good preventative care and supportive care during an outbreak sufferers are usually able to live long and productive lives.