Definition
Gout is a common, recurrent condition of joint inflammation in which crystals of uric acid are deposited within joints. More commonly seen in men than women, it most often appears in the big toe joint but can involve any of the joints in the foot.
If gout is left untreated, the joints involved may be damaged and surrounding tissues also may become inflamed. Some medications can cause gout, such as diuretics like hydrochlorothiazide and furosemide, and some antibiotics.
Other things to consider are a family history, age 50 or higher, male gender, obesity, trauma or surgery, emotional stress and chemotherapy or radiation treatments. Even diet can play a role as large amounts of certain foods can lead to a problem.
Signs and symptoms
- Sudden, severe joint pain (within hours), especially the big toe. Sometimes the weight of bed sheets may even be intolerable. The individual may be awakened from sleep due to the sudden pain.
- Joint is red, hot and swollen.
- Skin overlying the swollen joint may be tight and shiny.
- Painless, firm nodules on the external cartilage of the ear, sometimes seen on the fingers, hands, feet, Achilles tendon and under-surface of forearm. This is rare and usually occurs over time; it happens in what is known as chronic tophaceous gout. The nodules are called tophi (singular is tophus).
Treatment
The goal of gout treatment is pain relief. The gout attack will last 5-14 days without treatment. Once the 1st attack is over there are preventative measures you should take.
- NSAIDs (nonsteroidal anti-inflammatory drugs).
- Cortisone injections
- Other medications – colchicine, indomethacin, prednisolone.
- Warm or cold compresses on affected joints.
- Keep bedclothes off of painful joint; design a frame that raises the sheets and blankets.
- Diet – avoid sardines, liver, kidney, sweetbreads, red meat, cheese, chocolate and anchovies. Drink lots of water to help flush out the kidneys and prevent stone formation.
- Avoid alcohol as it can trigger or worsen a gouty attack.
- Lose excess weight but do it slowly and under the guidance of a physician. Crash diets with rapid weight loss can trigger an attack.
