Gout
DEFINITION
Gout is an arthritic condition of the body connected with an
excess of uric acid in the blood. It causes the joints to become
red, swollen and painful. Uric acid crystals are deposited in
joints, tendons, kidneys and other tissues where they cause
inflammation and damage. The most common area on the body for Gout
to occur is the joint of the big toe. Gout is not a single disease
but is a syndrome resulting from high levels of uric acid in the
blood.
excess of uric acid in the blood. It causes the joints to become
red, swollen and painful. Uric acid crystals are deposited in
joints, tendons, kidneys and other tissues where they cause
inflammation and damage. The most common area on the body for Gout
to occur is the joint of the big toe. Gout is not a single disease
but is a syndrome resulting from high levels of uric acid in the
blood.
DESCRIPTION
Gout is primarily a disease affecting adult men. It is
characterised by high levels of uric acid in the body. Uric acid is
the end product of metabolism of the class of chemicals known as
purines. Uric acid is a byproduct of certain foods, so Gout is
closely related to the diet. Some degree of kidney dysfunction
occurs in most people with Gout and there is a higher risk of
kidney stones. Gout may be associated with psoriasis, thyroid and
parathyroid disease, cardiovascular disease, obesity and high blood
pressure.
characterised by high levels of uric acid in the body. Uric acid is
the end product of metabolism of the class of chemicals known as
purines. Uric acid is a byproduct of certain foods, so Gout is
closely related to the diet. Some degree of kidney dysfunction
occurs in most people with Gout and there is a higher risk of
kidney stones. Gout may be associated with psoriasis, thyroid and
parathyroid disease, cardiovascular disease, obesity and high blood
pressure.
CAUSE
There are several possible causes of Gout. They include:
- Foods high in purines increase uric acid levels. See the Diet
section in this topic. A high intake of protein, saturated fats,
refined carbohydrates, coffee and meat, and a low intake of fruits
and vegetables may also cause Gout. - Drugs such as aspirin, penicillin, diuretics and insulin may
reduce the ability to excrete uric acid from the body. - Alcohol increases uric acid production and reduces uric acid
excretion. Alcohol may also impair kidney function. - Obesity may cause Gout.
- Hereditary factors.
- Insufficient exercise.
- Kidney disease or dysfunction leads to decrease clearance of
uric acid. - Lead toxicity.
Aspirin should not be given to children under 16 years of age
unless specified by a Doctor.
unless specified by a Doctor.
SIGNS AND SYMPTOMS
Gout is characterised by intense pain, usually in the big toe.
Other joints such as ankles, mid-foot, knee, wrists and even the
fingers can be affected. Attacks of Gout pain often increase in
colder weather. The feet do not have a strong blood circulation and
that is why crystals of uric acid form in the big toe. These
crystals are very painful. In an attempt to reduce the pain of
Gout, keep feet warm. First attacks of Gout usually occur at night
with a throbbing pain and are usually short lived.
Other joints such as ankles, mid-foot, knee, wrists and even the
fingers can be affected. Attacks of Gout pain often increase in
colder weather. The feet do not have a strong blood circulation and
that is why crystals of uric acid form in the big toe. These
crystals are very painful. In an attempt to reduce the pain of
Gout, keep feet warm. First attacks of Gout usually occur at night
with a throbbing pain and are usually short lived.
TREATMENT OPTIONS
As with all conditions your Doctor should be consulted to
diagnose and treat this condition. A simple blood test will
diagnose the problem immediately. Usually any prescribed medicine
is directed towards reducing the content of the uric acid in the
blood and relieving the symptoms. Some patients have to take
medication for long periods of time.
diagnose and treat this condition. A simple blood test will
diagnose the problem immediately. Usually any prescribed medicine
is directed towards reducing the content of the uric acid in the
blood and relieving the symptoms. Some patients have to take
medication for long periods of time.
A variety of over-the-counter topical analgesics are
available. These are usually creams or gels which may be rubbed
into the painful area several times a day. Such creams should not
be applied to broken or irritated skin, and hands must be washed
well after application. If it is your hands that are being treated,
wear a pair of light cotton gloves to prevent creams from getting
into the eyes. Creams may interact with oral medications, so always
ask your Doctor or Pharmacist before commencing a new
treatment.
available. These are usually creams or gels which may be rubbed
into the painful area several times a day. Such creams should not
be applied to broken or irritated skin, and hands must be washed
well after application. If it is your hands that are being treated,
wear a pair of light cotton gloves to prevent creams from getting
into the eyes. Creams may interact with oral medications, so always
ask your Doctor or Pharmacist before commencing a new
treatment.
DIET HINTS
See the topic Gout Diet on the Healthpoint.
- Avoid foods high in purines such as liver, kidney, heart,
brains, pate, sardines, herrings, anchovies, mackerel, shellfish
such as prawns and scallops, fish roe (fish eggs), yeast, beer,
asparagus and yeast products. For a complete list of high, moderate
and low-purine foods see the purines topic. - Drink plenty of water.
- Avoid alcohol.
- Minimise fructose (fruit sugar) intake.
- Reduce saturated fat intake as this may increase uric acid
retention. - Juices such as celery, alfalfa and carrot may help remove
excess uric acid from the body.
VITAMINS/MINERALS/HERBS
Nutritional supplements may only be of assistance if the
dietary vitamin intake is inadequate.
dietary vitamin intake is inadequate.
- Folic Acid may help reduce uric acid levels.
- Vitamin C, (500mg per day), has been shown to help reduce uric
acid levels in the blood - Celery Seed (Apium graveolens) may help reduce uric acid levels
and also has anti-inflammatory actions. - Ginger may help decrease inflammation.
- Nettle root may encourage the elimination of uric acid from the
kidneys. - Fish Oil can assist with reducing inflammation in the
joints. - Bromelain may dissolve uric acid crystals and can bring relief
to a joint also inflammed by injury. - Quercetin has natural anti-inflammatory effects and may prevent
uric acid from forming. - Devil’s claw may relieve short term pain and inflammation.
ORGANISATIONS & SUPPORT GROUPS
See the Arthritis Foundation of Australia topic on the
Healthpoint.
Healthpoint.
PHARMACIST’S ADVICE
Ask your Pharmacist for advice.
- Follow the Diet Hints.
- Drink 6 to 8 glasses of filtered water a day. An increase in
filtered water intake can help the body excrete excess uric
acid. - Ask your Pharmacist about non-steroidal anti-inflammatory
(NSAID) medication such as ibuprofen to help relieve pain - Your Pharmacy may stock a range of herbal tablets, capsules or
liquids that help to reduce the swelling associated with Gout by
removing excess fluid from the body (diuretics) e.g., celery,
juniper. - Keep the bodyweight within normal range. Gout is often
associated with obesity. Ask your Pharmacist for help if you need
to reduce weight. - Avoid alcohol, especially beer. Alcoholic beverages are
unsuitable for Gout sufferers as they decrease the excretion of
uric acid from the kidneys. - Avoid aspirin as it may aggravate the condition.
- If the diet is inadequate, consider taking some nutritional
supplements. 500mg of vitamin C daily has been shown to help reduce
uric acid levels in the blood
