WHAT IS GOUT?Gout is a condition in which painful inflammation can develop in the joints (arthritis). The inflammation is caused by the accumulation of uric acid crystals in the joint. Uric acid levels in the blood are usually also too high. The uric acid crystals irritate the joint and cause pain, redness, and swelling. The big toe is usually affected, but sometimes the midfoot, ankle, knee, wrist, or one of the hand joints.
The inflammation can flare up quickly ( a gout attack ), causing the big toe to become swollen, red, painful, and warm. It usually heals within 1-3 weeks, but gout attacks can recur over time.
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gout arthritis |
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Gout can also cause accumulations of uric acid crystals in the skin. These are called gouty tophi . These are small, hard lumps that can be felt under the skin. Sometimes a few, sometimes many. Gouty tophi most commonly appear on the fingers, toes, knees, elbows, the outer ear, and heels. Sometimes the skin over the gouty tophi breaks, releasing uric acid crystals, a whitish, granular substance. Uric acid crystals can also form kidney stones.
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HOW DOES GOUT DEVELOP?Gout is caused by an increase in the amount of uric acid in the blood. High uric acid levels can lead to the formation of crystals that can deposit in joints, the skin, or the kidneys. In the joint, the urate crystals cause inflammation. Not everyone with elevated uric acid levels develops gout; the risk is only 1 in 10. The risk is higher if gout runs in the family. Gout is more common in middle-aged men, those who are overweight, and those with high blood pressure or cardiovascular disease. Diet and alcohol do not appear to play a role in the development of gout attacks.WHAT CAN I DO ABOUT GOUT?If a joint is swollen, red, warm, and painful, you should avoid it. Elevate the joint and cool it with a wet compress or ice. Once the symptoms subside, it's important to start moving regularly again. This prevents stiffness and can reduce the pain over time. Avoid heavy or prolonged strain initially.TREATMENT OF GOUTNSAIDsIn an acute attack of gout with inflamed, painful joints, anti-inflammatory painkillers are prescribed. Examples of these painkillers include diclofenac, naproxen, and ibuprofen. These medications can reduce the pain within one or two days. These anti-inflammatories are called NSAIDs, which is an abbreviation of the English term non-steroidal anti-inflammatory drugs. These NSAIDs can cause stomach upset, so an antacid is sometimes prescribed as a precaution.PrednisoneIf NSAIDs cause too many side effects or are ineffective, prednisone can be used for a short period. Prednisone (corticosteroid) can also be injected into the body. Its effect can last for about 3 months. An antacid is also often prescribed with prednisone, especially if NSAIDs are also used.ColchicineIf NSAIDs or prednisolone don't help within three to five days, the next step is to prescribe colchicine. Colchicine is an antigout medication. It reduces pain and inhibits inflammation. The dosage is one 0.5 mg tablet two to three times a day until the pain subsides. If the pain persists after several days, there's no point in continuing the medication. If side effects such as a burning sensation in the throat, nausea, abdominal cramps, or diarrhea occur, you should discontinue colchicine.AllopurinolIf gout attacks occur frequently (more than three attacks per year), it's helpful to start using allopurinol. This medication lowers the amount of uric acid in the blood. This reduces or eliminates gout attacks, and the gout nodules (tophi) can disappear after six months to a year.WHAT ARE THE OUTLOOK?An attack of gout can last one to three weeks, after which the joint heals completely. |
