Summary about Disease
Gout is a common and complex form of arthritis characterized by sudden, severe attacks of pain, swelling, redness and tenderness in one or more joints, most often in the big toe. It occurs when urate crystals accumulate in your joint, causing inflammation and intense pain. Excess uric acid in the blood (hyperuricemia) is the underlying cause.
Symptoms
Intense joint pain, typically in the big toe, but can affect other joints like ankles, knees, elbows, wrists, and fingers.
Lingering discomfort after the initial severe pain subsides.
Inflammation and redness in the affected joint.
Limited range of motion in the affected joint.
Causes
Gout is caused by hyperuricemia, which occurs when the body either produces too much uric acid or doesn't eliminate enough of it. Factors that can increase uric acid levels include:
Diet rich in purines (red meat, organ meats, seafood).
Excessive alcohol consumption (especially beer and spirits).
Certain medical conditions (kidney disease, diabetes, metabolic syndrome).
Certain medications (diuretics, aspirin).
Genetic predisposition.
Obesity.
Medicine Used
Nonsteroidal anti-inflammatory drugs (NSAIDs): Such as ibuprofen or naproxen, to reduce pain and inflammation during an acute attack.
Colchicine: An anti-inflammatory drug specifically used for gout, most effective when taken within the first 24 hours of an attack.
Corticosteroids: Such as prednisone, used to reduce inflammation and pain, either orally or injected into the joint.
Urate-lowering medications:
Allopurinol and Febuxostat: Reduce the body's production of uric acid.
Probenecid: Helps the kidneys remove uric acid from the body.
Pegloticase: Converts uric acid to a harmless substance that is excreted in the urine (used for severe cases).
Is Communicable
No, gout is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Dietary changes: Limit purine-rich foods (red meat, organ meats, seafood), and sugary drinks.
Limit Alcohol: Avoid or limit alcohol consumption, especially beer and spirits.
Maintain a healthy weight: Obesity increases the risk of gout.
Stay hydrated: Drink plenty of water to help your kidneys function properly and excrete uric acid.
Medication adherence: Take prescribed medications as directed to manage uric acid levels.
Regular exercise: Promotes overall health and can help maintain a healthy weight.
How long does an outbreak last?
An acute gout attack typically lasts for 3 to 10 days, even without treatment. With treatment, the attack might resolve faster. If left untreated attacks can occur more frequently and become longer and more intense over time.
How is it diagnosed?
Joint fluid analysis: A sample of fluid is taken from the affected joint to look for urate crystals under a microscope. This is the most definitive test.
Blood test: To measure uric acid levels in the blood. However, elevated uric acid alone doesn't confirm gout, as some people with high levels never develop gout, and some people with gout have normal uric acid levels during an attack.
X-rays: May be used to rule out other causes of joint pain. Chronic gout can cause joint damage visible on X-rays.
Ultrasound: Can detect urate crystals in joints.
Dual-energy computed tomography (DECT): Can identify urate crystal deposits in joints, even when they are not inflamed.
Timeline of Symptoms
Hyperuricemia (years): Elevated uric acid levels may exist for years without causing symptoms.
Acute attack (days): Sudden onset of intense pain, swelling, redness, and tenderness in the affected joint. The pain typically peaks within 12-24 hours.
Intercritical period (weeks/months/years): Period between attacks, where the affected joint may feel normal.
Chronic gout (years): If untreated, attacks become more frequent, longer, and can involve multiple joints. Tophi (urate crystal deposits) can form under the skin and in joints, leading to chronic pain and joint damage.
Important Considerations
Gout is a chronic condition that requires long-term management, even between acute attacks.
Lifestyle modifications (diet, weight management, alcohol limitation) are crucial for managing gout.
Medications are often necessary to lower uric acid levels and prevent future attacks.
Early diagnosis and treatment can prevent joint damage and improve quality of life.
Complications of gout can include kidney stones, chronic joint damage, and tophi formation.
Consult with a healthcare provider for proper diagnosis and management of gout.