Gout is a disease that has been well-documented in history. It was first identified in ancient Egypt, and was termed “the unwalkable disease” by Hippocrates. Due to the severe pain that it can inflict, it has sometimes been depicted as being demonic in origin. It is also very recognizable as it tends to occur in the big toe.
Gout is a type of inflammatory arthritis that causes joints to be swollen, red, and tender. It typically affects the lower extremities, especially the big toe. Gout is usually characterized by gout flares, which are periods in which the affected joints flare up and the pain is especially severe.
Gout is caused by excessive levels of uric acid in the blood. When uric acid is present in high amounts in the body, it can crystallize and deposit itself in soft tissue, including joints. Excessive levels of uric acid in the blood can be caused by genetics or diet (typically meat, shellfish, sugary drinks, and alcohol).
Gout can be diagnosed by taking samples of the synovial fluid (the fluid within the joint space). In a patient with gout, the synovial fluid samples will show the presence of urate crystals. A blood test will often show high levels of uric acid. X-rays can also be useful in the diagnosis of gout. A joint tap (or a joint aspiration) is an even better diagnostic tool.
Treatment and Prevention
The most common medication prescribed for patients suffering from gout is allopurinol, which reduces the amount of uric acid in the body. In an acute attack, patients can be prescribed painkillers (like NSAIDs), colchicine (for patients who cannot tolerate NSAIDs), and steroids (which reduces inflammation). The first goal in an acute attack is to reduce the pain of the flare-up.
Ultimately, the best treatment for gout is a combination of medication and lifestyle changes. Patients should avoid purine-rich food (as mentioned above) that can lead to an accumulation of excess uric acid in the body. Controlling the levels of uric acid in the body is the best way to prevent the likelihood of future gout flares from occurring.