Gout is a form of arthritis, which is characterised by an acute swelling at one or sometimes multiple joints. The inflammation in gout is caused by a precipitation of monosodium urate crystals (uric acid) in the tissues.
The most common site for gout to occur is in your 1st metatarsophalangeal joint – your big toe joint but it can also commonly occur in your ankle, knee, wrist and elbow. The pain is usually progressive and can be excruciating, the symptoms can come on quickly and often worsen during the night. The affected joint usually shows signs of inflammation- redness, swelling, heat and where there is localised swelling the skin can become shiny looking with a red/purple look. The patient may also complain of feeling generally unwell, with fever and malaise.
There are three main reasons for elevated urate levels, causing gout:
– Decreased excretion
– Increased production
– Increased purine intake
Decreased excretion of uric acid is the most common cause and sometimes there is a hereditary link.
How is gout diagnosed?
A diagnosis is usually made of synovial fluid analysis and clinical criteria. When visiting your GP they may remove some fluid from that joint and have it analysed. Gout can start for no obvious reason, but in some cases it starts after a trauma, e.g. after stubbing your toe, following surgery, or after a medical stress e.g. an infection elsewhere in the body.
Your doctor will be able to prescribe medication to help control the symptoms of gout, but treating gout with a multi-disciplinary approach can also be beneficial.
Diet plays an important role in gout as its basic cause is incomplete purine metabolism, so avoiding purine rich foods such as red meat, liver & yeast can be helpful. Cherries have been shown to be helpful because of an enzyme they contain. Drinking plenty of water will also help.