Gout is a common enough condition in adult men - and contrary to popular belief it is not brought on by gluttony and boozing!
What causes Gout?
The condition arises because crystals of uric acid get deposited within a joint. This causes the tissues around the joint to become inflamed, stimulating the sensitive nerve endings and causing excruciating pain.
The most commonly affected joint is that at the base of the first toe. However, gout can affect any synovial joint in the body - and has been known to cause a painful swelling of the elbow, knee and wrist.
Uric Acid and Gout
Uric acid is formed in the body from substances called Purines - protein components of food that occur in high proportion in dairy products like milk, cheese and ice cream, red meats like lamb and beef (especially organ meets like liver, kidney and brain), sausages, shellfish, alcohol and peanuts.
Uric acid is naturally found in our blood, being a by-product of the breakdown of these proteins. Higher than normal levels of uric acid result either from a higher than normal of intake of foods that are rich in Purines, or a lower than normal ability of the body to excrete uric acid. Certain medications - for example, diuretics that are given to control high blood pressure and heart failure, can also result in raised uric acid levels and thus bring on gout.
Acute Attacks of Gout
Treatment of acute episodes includes the use of Prednisone or non-steroidal anti-inflammatory medications such as Indocid or Clinoril. Control of pain may require a mild narcotic such as codeine. Other treatment may include Colchicine which yields dramatic results but carries severe side effects which include nausea and severe diarrhea. Colchicine is taken once every two hours until the desired (or undesired) effects are achieved.
The most significant consideration in the treatment of gout is the frequency of attacks. Frequent attacks (more than one a year) will result in progressive erosion of the joint, leading to painful chronic arthritis. Isolated attacks (less that one a year) lead to minimal destruction of the joint. The frequency of gouty attacks determines whether treatment is merely for each attack, or whether daily medication should be taken to lower levels of serum uric acid.
Treatment of Gout
Treatment of recurrent attacks includes modifications in diet as well as the use of medications like Allopurinol, (which inhibits formation of uric acid) and Probenecid and Sulfinpyrazone that are used to increase the output of uric acid by the kidney. Dosing and combination therapy depends upon the level of serum uric acid which must be measured periodically during therapy.
Stones in kidney
Individuals prone to gouty attacks should also maintain a high fluid intake to promote the excretion of uric acid and decrease the tendency to form uric acid stones in the kidney and bladder.
Gout is one of the oldest disorders known - and well known sufferers from the condition include Alexander the Great, Michelangelo,Henry the Eighth, Isaac Newton and Benjamin Franklin.
 |
 |
