Gout is a type of arthritis characterised by attacks of pain, redness and tenderness in joints, often at the base of the big toe or ankle.
An attack occurs suddenly, often in the middle of the night, causing an individual to wake up feeling like his/her foot is on fire. The joint feels hot, swollen and extremely tender.
Gout causes are attributed to the buildup of uric acid crystals in the joints, formed by the breakdown of old cells and certain food and drink. If your body produces too much of it or does not expel it properly, tiny crystals are deposited in soft tissue and joints. Gout has numerous triggers and its risk factors vary.
What are its symptoms?
As an old medical textbook states: put your joint in a vice, turn it as tight as you can – that’s arthritis, give it one more turn – that’s gout.
Gout symptoms include:
- The affected joints become swollen, tender, warm and red.
- Intense joint pain, which is usually most acute within the first four to 12 hours.
- Some joint discomfort can last from a few days to weeks.
- Decreased joint mobility as gout progresses.
Gout will progress through three stages, namely:
- High uric acid levels in your blood, but no symptoms. Some people may have kidney stones before having their first attack of gout.
- Uric acid crystals begin to form, usually in the big toe. You begin to have gout attacks. After an attack, the joint feels normal. The time between attacks may grow shorter. Later attacks may be more severe, last longer, and affect more than one joint.
- Symptoms may never go away. They may affect more than one joint, and gritty nodules called tophi may form under your skin.
How is it diagnosed?
A gout diagnosis can be difficult because many other types of inflammatory arthritis also produce hot, stiff, inflamed and painful joints. There’s also no sole test or examination. Your doctor will need to examine you and question you about your symptoms and medical history.
The most common tests to check for gout include a joint fluid (synovial fluid) test to check for uric acid crystals and a blood test. There is also X-ray imaging (which does not actually detect gout but rules out other conditions) and a musculoskeletal ultrasound, which can reveal crystals in joint cartilage and deep in the skin.
What are your treatment options?
Gout treatment options should include immediate relief of the acute symptoms and the prevention of future attacks. For instant relief, apply ice to the inflamed joint, keep it elevated and away from heavy sheets and blankets. Stay hydrated, as water can help flush out the uric acid crystals.
Depending on the cause and severity of the attack, you can also take over-the-counter anti-inflammatory medication such as ibuprofen. For severe, recurring gout, ask your doctor about gout medication.
Can it be prevented?
There is no cure for gout. It is a condition that is treated rather than cured. A certain diet can trigger gout. Limit your intake of alcohol, fats and foods that are likely to increase the levels of uric acid in your body. Foods to avoid include red meat, bacon and yeast.
Also keep your weight under control, drink plenty of liquids — this minimises the risk of kidney stones — and have occasional blood and urine tests. These will determine your risk of a gout attack.
Medication that lowers the levels of uric acid in the blood will also help prevent further gout attacks.