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Gout What is gout? Gout is a type of arthritis that is caused by uric acid crystals getting caught in the spaces between the joints of the feet, the hand and some larger joints. The tissue around the joints becomes inflamed, and this inflammation triggers the sensitive nerve endings at the joint, causing extreme pain. Uric acid is a waste product from the body, especially from proteins called purines. It is passed out in the urine by the kidneys, which sometimes cannot cope with the load of uric acid, and this causes a build-up in the body. What are the symptoms? The main symptom is severe pain, usually in the hands or feet, especially at the base of the big toe. Sometimes gout can strike in other joints, such as the elbow or the knee. The pain usually comes on without warning, often in the early hours of the morning, and soon the joint becomes so tender that one cannot bear even the weight of the bed sheets. The inflamed skin over the joint is often red, shiny and dry. The first attack usually involves only one joint and may last from a few hours to several days, generally about 2 or 3 days depending on how soon treatment is commenced. Sometimes there may be only one attack in a person's lifetime. Who gets gout? Almost any person can get gout, because all human beings produce about as much uric acid as the kidneys can handle. However, it does appear to be hereditary and is far more common in men, especially between the ages of 30 and 60. It is one of the oldest disorders known to humans, and some well-known victims include Alexander the Great, Kublai Khan, Michelangelo, Martin Luther, Isaac Newton, Henry VIII, John Wesley, Francis Bacon and Benjamin Franklin. What brings on gout? Contrary to popular belief, it is not necessarily brought on by high living and gluttony. Overindulgence in rich foods and alcohol can certainly bring on an acute attack in those who are prone to get gout. It is associated with obesity and high blood pressure. Some drugs, particularly diuretics (fluid tablets), and injury can bring on gout. What are the risks? Gout is a curable disease, but if it is untreated it can cause kidney disease, including kidney stones. What is the treatment? The acute attack The earlier the attack is treated the better. Contact your doctor about the best treatment and the right pain-killer. Aspirin is not recommended for the pain of gout. Bed rest is important. Some relief can be obtained by applying a hot compress or ice to the affected joint. Keep the weight of the bedclothes off the foot by placing a bed cradle or similar object under the bedclothes. Since gout may strike only once, no further treatment is needed apart from following the 'rules of moderation'. If gout keeps returning, it will be necessary to go onto tablets that may have to be taken for a lifetime in order to prevent more acute attacks.
Rules of moderation Do:
Don't:
Copyright 1995: John Murtagh, Professor of
General Practice
North
East Valley Division General Practice, Victoria,
Australia, Disclaimer |
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