Patient Education

GOUT

Gout

  • Gout has been known as “Disease of Kings” as it is seen in wealthy people.
  • Gout is a type of inflammatory arthritis.
  • It occurs due to accumulation of uric acid crystals in the joints
  • People with gout develop sudden onset painful swelling of the big toe over the night
  • Apart from great toe it can affect other joints
  • It mostly affects men with age of more than 40yrs and post menopausal women
  • Gout is also commonly seen with kidney disease patients
  • Gout is the inflammatory arthritis due to deposition of uric acid crystals in the joint.
  • Whenever there is deposition of uric acid crystals in the joint the body’s own immune system attacks it and inflammation takes place leading to joint pain and swelling.
  • Gout is also known as “the disease of kings” because another reason is related to diet that is, eating a diet that is rich in meats, alcohol.
  • Kidney helps in removing of excess uric acid from the blood and prevents getting accumulated in the body. So whenever there is kidney disease uric acid gets accumulated in the body.
  • There are certain risk factors associated with GOUT
  • Foods with rich in red meat
  • Alcohol
  • Soft drinks and fruit juices
  • High fructose drinks
  • Icecream
  • Some medication eg- thiazide / furesamide diuretics , Pyrezinamide
  • Patients with kidney disease
  • Rarely associated with genetic disease
  • Other diseases such as diabetes, obesity and high blood pressure

  • This disease basically affects men in their older age and almost never affects women until after they reach menopause or have any kidney problem.
  • Gout is commonly seen in people with diabetes, high blood pressure and obesity (Metabolic syndrome)
  • Patients with long term kidney disease
  • Those taking excess amount of red meat, sea food, alcohol and soft drinks
  • Sometimes gout can be heriiditary i.e runs in family
  • People with certain cancer who are on chemotherapy
  • It can be diagnosed with detail history and examination
  • It is confirmed with blood tests, joint fluid examination
  • Sometime Ultrasound of the joint helps in diagnosis
  • Joint fluid test- Fluid can be removed from the joint and examined for the uric acid crystals
  • Blood test-
    o Blood Uric acid-Patients with gout have increase in uric acid level in the blood. But some time during the attack time the uric acid may be low, so you have to repeat after 2-3 wks of attack.
    o Serum Creatinine-For the kidney function test. To look for the kidney function status as uric acid removed by the kidney
  • Xray- Erosion of the bone
  • Ultrasound of the Joint-Identify the tophi, demonstration of the double contour sign

  • Sudden painful swelling of the joint as people mistakenly think that it has some infection occurred in the joint.
  • Patients usually tell that it has developed over the night, on the early morning not able to put the foot on the floor as if “some insect bite took place”.
  • It usually attacks one joint joint at a single time
  • Gout patients get affected at the big toe then gradually it affects the other joints.
  • Gout mostly affects other joints that include, ankle, knees, wrists, elbows, fingers.
  • Whenever the attacks occur the joint pain and swelling usually persist for 7-10 days
  • Some time the uric acid crystals gets deposit and form hard nodule over the develops over elbows, backs of the hands and in the finger pads known as “GOUTY TOPHI”
  • This long term condition can damage the joints and even destroy them.
  • Gout during pregnancy is rare but it does occur and women are at a higher risk of developing gout when pregnant.
  • This is due to the increased weight during pregnancy and the altered hormonal levels, this can spike uric acid levels causing gout to pregnant women who are unable to control the uric acid production during this period.
  • It is very important to treat gout during the pregnancy to limit the discomfort it may cause.
  • Drinking lots of water will also help avoid having water retention a common symptom during pregnancy, plus it will promote a better metabolism.