GOUT Gout is a common and complex form of arthritis that ca
Dr. Atul Chowdhury
GOUT

Gout is a common and complex form of arthritis that can affect anyone. It's characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe.An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it may seem intolerable.Gout symptoms may come and go, but there are ways to manage symptoms and prevent flares.

SYMPTOMS

Gout usually affects the large joint of your big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins.After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.Limited range of motion.

CAUSES

Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood.Purines are also found in certain foods, such as steak, organ meats and seafood. Other foods also promote higher levels of uric acid, such as alcoholicbeverages, especially beer, and drinks sweetened with fruit sugar (fructose).Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes either your body produces too much uric acid or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needlelike urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.

RISK FACTORS

Diet.
Eating a diet rich in meat and seafood and drinking beverages sweetened with fruit sugar (fructose) increase levels of uric acid, which increase your risk of gout. Alcohol consumption, especially of beer, also increases the risk of gout.

Obesity
Hypertension
Diabetes
Metabolic syndrome
Heart and kidney disease
Medication like thiazides diuretics low dose aspirin.
Age and sex : more common in men between 30 to 50 but after menopause women too develop it commonly.
Recent surgery and trauma.

COMPLICATION

Recurrent gout.
Advanced gout:-Untreated gout may cause deposits of urate crystals to form under the skin in nodules called tophi .
Kidney stones.

PREVENTIONS

During symptom-free periods, dietary guidelines may help protect against future gout attacks like:-

Drink plenty of fluids.

Limit or avoid alcohol.

Limit your intake of meat, fish and poultry.
Maintain a desirable body weight.

TREATMENT

Drugs like allopurinol, febuxostat, rasburicase but during acute attack it needs analgesics like NSAID, colchicine. But u should consult your doctor

Dr Atul Chowdhury
GENERAL MEDICINE

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