Gout: Diagnosis And Treatment
Gout is a very painful and sometime debilitating joint disease caused by uric acid crystal formation in the joints
. However, early diagnosis, management and treatment, can result in decreasing the severity and the frequency of gout attacks. Most patients who are experiencing a gout attack usually complain of severe pain in the affected joint. This pain tends to be worse at night. One of the most common areas affected is the big toe joint at the ball of the foot. Typical symptoms that occur in a gout attack are hot and extremely swelling and redness. The pain can be very excruciating to the point that even light touch from bed sheets can cause pain.
Interestingly, the painful symptoms of gout usually occur during the night when the body temperature drops. Once the body temperature is lower, there is a higher occurrence of uric acid crystals that slowly begin to form in the joints. This process is very similar to dissolving sugar in hot water. When the hot water cools, the dissolved sugar slowly begins to reform similar to uric acid crystals formation in the foot when the body temperature decreases.
Origin of gout: Gout is a disease commonly found in older men and postmenopausal women. The causes of gout is divided into two categories, either the body overproduces uric acid, which is the main component of uric acid crystals, or the body under excretes uric acid. Under excreting uric acid is the most common cause of the two categories. However, in both cases, there is a high uric acid concentration in the body and thus increased formation of the uric acid crystals into the joints.
Diagnosis of gout: If gout is suspected, an X-ray may be taken of the foot to evaluate the joint. In a patient with chronic gout, the uric acid crystals can cause bone erosions that can be visualized on X-ray. Also, x-rays are taken to rule out the possible other causes for this type of pain, such as a fracture or arthritis. Blood tests may be performed to determine the amount of uric acid in the body. It should be noted, however, that there could be normal uric acid levels in the blood even though the patient has gout or symptoms of gout. Also, gout can be diagnosed by aspirating the joint. This procedure requires local anesthetic to numb the joint, then using a needle and syringe; a sample of joint fluid is removed for analysis. The joint fluid in gout has a white cottage cheese appearance as opposed to a normal joint that has clear joint fluid. This joint fluid is then sent to the lab for analysis. Uric acid crystals can be visualized in the lab using a microscope.
Conservative treatment One way to decrease the incidence of gout attacks is by changing to a diet that is low in red meats and shell fish. These food types are high in purine. Purine is a chemical that is broken down into uric acid in the body. Decreasing purine consumption results in less uric acid build-up and therefore, less chance of getting a gout attack.
Oral medication can also decrease the incidence and severity of gout attacks. Indomethacin, is a non-steroidal anti-inflammatory, it is used to decrease the swelling and inflammatory symptoms of gout.
Regular use of Colchicine may be recommended to prevent the inflammatory reaction to the uric acid crystals. This medicine can also be used to treat an acute gout attack.
In order to decrease the amount of uric acid in the body, another medicine called allupurinol may be used. This medicine inhibits the conversion steps of purine to uric acid and therefore prevents crystals from forming.
Copyright (c) 2010 Bruce Lashley
by: Bruce Lashley
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