Gout is an inflammation of the joints caused by having too much urate in your blood. Urate, or uric acid is produced by your body to break down purines in your food and drink. Purines are found in all living things including foods, as they make up the chemical structure of the cells. However, meat, fish and alcoholic drinks have the highest concentration of purines.
As purines are part of cells and cells die, they have to be broken down so that new cells can grow. This is the job of uric acid. If you have too much uric acid or your kidneys aren’t processing it efficiently then it can form into a crystal like substance which irritates your joints and causes pain and swelling. This is gout.
Why Do Some People have too Much Uric Acid?
There are lots of reasons:
• Eating foods with high levels of purines
• Drinking too much alcohol
• Having an underlying kidney disease
• Taking excess diuretics (too much tea, coffee, alcohol) or diuretic medicine
• Taking a vitamin B12 supplement can sometimes cause excess urate in prone individuals
• High blood pressure
• Family history of gout
• Having a very intensive exercise regime
• Injuring a joint – this can predispose you to having gout
• If you have cancer and have been having chemotherapy, this can increase your urate and put you at risk of gout.
Symptoms of Gout:
These include fever, warmth, redness and swelling around your joints, severe joint pain. If you have had gout before or have had it for a while, you may get hard lumps beneath the skin of the affected area.
Areas most affected by gout are your toes, feet, ankles, knees, elbows, fingers and wrists.
Diagnosis:
You will be offered an X-ray to rule out other causes of your symptoms, particularly if you think you have injured yourself or you participate in vigorous exercise. Fractures or sprains can cause similar symptoms.
If your X-ray is normal, you will be offered a blood test to check the levels of urate in your blood, although this can be inconclusive as other illnesses can cause high urate. Fluid can be removed from your affected joints to see if they contain urate crystals. If these are seen, then you will be diagnosed with gout.
Treatments:
Taking anti-inflammatory painkillers can help, unless your gout is caused by kidney disease. Don’t try this method of treatment if you have a heart condition as these types of painkillers can increase your risk of a heart attack.
If anti-inflammatory drugs aren’t suitable for you, there is a drug called colchicine that reduces urate crystals in the blood. It does, however, have some unpleasant side-effects. Sometimes it is possible to have steroid injections directly into the swollen joint, unless it’s in a very small joint like the toe.
Attacks of gout are always temporary and only usually last a couple of weeks, but once a person has suffered from it, it usually returns in bouts. If it is left untreated, the bouts become more frequent and the gout can last for longer, so seek advice from your health care practitioner.
Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting, in addition to running a charity for people damaged by vaccines or medical mistakes.