Gout

Gout is a chronic painful joint disease that is largely associated with the lifestyle as the uric acid plays a big role in the development of the disease (see below).

Cause

The cause of gout is too high level of uric acid in our body (so-called hyperuricemia). Uric acid is a metabolic product of purines that are parts of nucleic acids. Nucleic acids are present in nuclei of the cells. If we eat too much meat and animal innards, the nucleic acids from digested cells are transformed to purines and then to uric acid. Accumulated uric acid deposits within joints and causes the problems. Uric acid accumulates quicker in patients with chronic renal failure and its concentration may be elevated in extensive malignant tumors because of the disintegration of its cells.

Risk factors

The main risk factor is unhealthy lifestyle with excessive intake of meat products and deficiency of fruit and vegetables. Gout more often occurs in patients with increased intake of alcohol, although the precise effect of alcohol on uric acid level is not clear.

Symptoms

Concentrated uric acid forms crystals that accumulate in the joints. The joints are irritated and this causes a local inflammation. Local inflammation is accompanied with swelling, redness and pain of the affected joint. The most commonly affected is the big toe joint. The pain is very sharp and typically it occurs in bouts alternated with periods of calm. In chronic course of the disease, the uric acid may create bulgy deposits under the skin that are visible by naked eye.

Complications

Uric acid crystals can form not only in joints but also in kidneys forming urinary tract stones that can cause renal colic and other complications.

Prevention

The best prevention is a change of lifestyle and diet. Restriction of meat products and innards is the most important and this should be accompanied with reduction of alcohol intake.

Treatment

Sudden seizure is treated by administration of non-steroidal anti-inflammatory drugs. To prevent further bouts it is advisable to follow the dietary restrictions (see above) and administer a drug containing substance allopurinol. Allopurinol blocks the metabolic production of uric acid and thus helps to decrease its concentration in the body. If elevated levels of uric acid are related to a cancer or chronic renal failure, it is necessary to treat these underlying causes.