What you need to know about gout

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One in 10 Indians suffers from joint trouble, increasingly towards old age - and in about 20 per cent of cases, arthritis is to blame... I want to talk about a specific type of arthritis -- Gout.

Gout is a form of arthritis marked by sudden attacks of painful, inflamed joints... It's characterised by pain, swelling, redness, and warmth or inflammation as well as stiffness in a joint or joints. These are most common in the fingers of the hand and feet. Without treatment, gout attacks tend to recur and may cause severe damage to joints, tendons, and other tissues. Gout is most common in men.

And here's the thing - gout can INCREASE the risk of heart attacks...which makes it even more crucial to learn to recognise symptoms.

So here's some medical advice you need to know...

What causes gout?

Gout is caused by too much uric acid in the blood . Hyperuricemia or increased uric acid usually does no harm, and most people with high levels of uric acid in the blood never develop gout. The problem lies in the fact that uric acid may form crystals that accumulate in the joints. The exact cause of Hyperuricemia sometimes goes undiscovered, although genetics has a definite role. Gout can seem to flare up without specific cause or can be brought on by factors such as being overweight, eating meats and seafood that are high in chemicals called purines, taking certain medications (especially aspirin and diuretics), and especially, by drinking too much alcohol.

What are the symptoms?

Gout usually develops after years of buildup of uric acid crystals in the joints and surrounding tissues. The most common symptom of gout is a nighttime attack that produces swelling, tenderness, redness, and sharp pain . People who have gout may have a few very painful attacks in one or two joints, usually the big toe, foot, ankle, or knee joints. The attack can last a few days or as long as several weeks, and then the symptoms disappear completely. Another attack may not occur for months or years.

How is gout diagnosed?

A physical examination and complete medical history will help you and your health professional identify the cause of your symptoms. Although several tests can support a diagnosis, the joint fluid aspiration test, which checks for the presence of uric acid crystals in the joint fluid, is considered most helpful. Your health professional will probably also do a blood test to measure the uric acid content in your blood

Initial treatment

Gout is treated with medications to relieve symptoms and measures to eliminate causes. Specific treatment depends on whether you are having an acute attack or are trying to prevent future attacks.

To reduce the pain, swelling, redness, and warmth of the affected joint(s) in an acute gout attack:

Rest the affected joint(s).

Take one or more of the following medications at the first sign of a gout attack, as prescribed by your health professional.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or indomethacin are likely to be prescribed. Avoid aspirin because it may abruptly change uric acid levels in the blood and may make symptoms worse.

The goals of treatment for gout are pain relief and prevention of future gout attacks. It is important to avoid long-term complications, such as joint destruction and kidney damage.

For more information on gout, and if you're worried that you might have it, make an appointment with YOUR doctor, and get your symptoms checked out.

Till next week...stay healthy!

(Dr Amit Varma is Chief Operating Officer and Director Critical Care Medicine at Fortis Flt Lt Rajan Dhall Hospital in Delhi)