Arthritis is an inflammation of the joint. One of the most common forms of this condition is gout. This is also considered as one of the most painful rheumatic diseases. Gout occurs in about 840 out of every 100,000 people and is very common in New Zealand among the Maoris and the Pacific Islanders. It is common among men and women who have already undergone menopause. The condition usually affects the ball of the big toe but can also affect the instep, ankles, heels, knees, wrists, fingers and elbows. It usually affects one or two joints at a time and appears as an acute attack overnight. Within 12 to 24 hours, the individual can experience pain and swelling in the affected area.
There are four stages in the development of gout. The first stage is known as asymptomatic hyperuricemia. This is when an individual’s uric acid in the blood is higher than normal but there are still no symptoms visible. In the second stage, acute gout, the high level of uric acid now causes a sudden and very painful swelling in the joints. The first attacks may only last for three to ten days without treatment and the next attacks could be for months or even years. However, the frequency of the attacks may happen more and longer over time. Interval gout, the third stage of development, involves the acute attacks of the condition. The forth stage is the chronic tophaceous gout. This is the most disabling stage of gout and usually develops over a long period. Permanent damage to the affected joints and even the kidneys can be caused by this last stage of gout.
The main cause for having gout is hyperuricemia. This is brought about by high uric acid in the blood. These excess of uric acid will form microscopic crystals in the joint and will in turn cause inflammation. This high level could be due to a hereditary factor. More than 18 percent of people who have gout have a family history of the disease. High intake of food that contains purines may also be another cause of developing gout. So are high alcohol intake, obesity and an exposure to lead. Some medications may also contribute to the development. Diuretics is one form of medication that decreases the uric acid passed in the urine. Other medications are salicylates, niacin, cyclosporine and levodopa.
If gout is not treated complications may arise. Tophi, a chalk colored nodule could be developed over time. This happens when the deposits of uric acid salts may appear around the affected joint and even in tissues. Another complication that may arise is high blood pressure as most high uric acid levels are leads to this. High blood pressure combined with hyperuricemia can also lead to kidney damage.
Anti-inflammatory drugs of NSAIDs are one form of medication prescribed by doctors to treat gout. Some examples of this drug are indomethacin and naproxen. These are taken orally and daily. Corticosteroids are another form of medical treatment. The most common of this is prednisone. These can be taken orally or injected into the affected joint. With effective treatment, the symptoms can be controlled within 12 to 24 hours and no further treatment is necessary. However, if NSAIDs and corticosteroids does not prove to be effective for the individual, colchicine is prescribed. Medications that will lower the uric acid also need to be taken as attacks may continue as long as this problem is not treated. A proper diet also needs to be followed by the patient. Some food may make gout more painful. So, certain food should be avoided. This includes red meat from cows or sheep, kidneys, liver and heart parts, shellfish, peas and beans. Alcohol especially beer and wine should also be avoided.
