Gouty arthritis is due to excess accumulation of uric acid in the blood. It is much more common in men than women. The excess uric acid in the blood may accumulate in the joint that leads to irritation of the joint lining, causing pain and swelling of the affected joint. Gout usually starts at the base of the great toe. Usually the attack starts in the midnight or early morning. The affected joint is usually red, swollen; warm and very tender to touch .the initial attacks will subside within days with or without treatment. Gradually it may spread to the other joints of the hands and feet and major joints like knees.
In the initial stages, between the attacks the patient may feel fine without any pain and swelling in the joints. After a few years, patients may get very frequent attacks. Excess uric acid in the blood is either due to excess synthesis of uric acid or decreased excretion of uric acid through the kidneys. It may run in families. Excess alcohol intake and sometimes tablets like diuretics also can cause Gout. Uric acid may also get accumulated in places other than joints, for e.g.: ear (under the skin).They appear like little white nodules called Tophi. Gout is usually associated with obesity, hypertension, diabetes and high cholesterol .An untreated gout can cause kidney failure or the kidney failure patient per se can get gout due to accumulation of excess uric acid in the blood.
There is another type of arthritis associated with high uric acid – Psoriatic arthritis. This high uric acid in Psoriatic arthritis will not cause gout. The routine laboratory tests for diagnosing gout are estimation of serum uric acid, examination of joint fluid for uric acid crystals and radiographs of involved joints. The medications available for gout are pain killer [NSAIDS], Colchicine, Allopurinol, probenecid and occasionally steroids.
The important things to remember in the diet are avoid or reduce the amount of Alcohol intake [3-4 units / day for men, 3-2 units/ day for women], reduce the intake Of foods rich in purine for e.g. Spinach, cauliflower, cabbage, mushrooms, beans, red meat and animal internal organs.
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