Gout

Gout, also known as gout or podagra, is a form of arthritis caused by the deposition of monosodium urate crystals in the joints and soft tissues. The disease is characterized by recurrent attacks of acute, very painful inflammation of the joints, most often affecting the base of the big toe.

Gout is the result of high levels of uric acid in the blood (hyperuricemia). Uric acid is an end product of purine metabolism. When its levels in the body become too high, it forms crystals that are deposited in the joints, causing inflammation and pain.

A typical gout attack begins suddenly, often at night, and is characterized by intense pain, swelling, redness, and warmth in the affected joint. Although it most often affects the base of the big toe, it can also occur in other joints, such as the ankles, knees, wrists, and elbows. Untreated gout can lead to chronic arthritis, tophi, and kidney damage.

 

Gout prevention

• Reducing the consumption of foods rich in purines (e.g. red meat, seafood, offal).
• Reducing alcohol consumption, especially beer and spirits.
• Reducing the consumption of fructose-sweetened beverages.
• Maintaining a healthy body weight.
• Regular physical activity.
• Drinking plenty of water.
• Reducing salt intake.
• Increasing the consumption of low-fat dairy products.
• Regular monitoring of uric acid levels in the blood.
• Avoiding fasting and diets that drastically restrict calories.
• Treatment of comorbidities such as hypertension, diabetes or hyperlipidemia.

 

Treatment of gout

The treatment of gout aims to alleviate the symptoms of an acute attack, prevent further attacks and reduce the level of uric acid in the blood. In an acute attack, anti-inflammatory drugs (NSAIDs), colchicine or corticosteroids are used to relieve pain and inflammation. Patients are advised to rest and elevate the affected joint, and apply cold compresses.

Long-term treatment focuses on lowering the level of uric acid in the blood. Medications that inhibit the production of uric acid (e.g. allopurinol, febuxostat) or increase its excretion by the kidneys (e.g. probenecid) are used. Therapy is usually long-term and requires regular monitoring of uric acid levels.

An important element of treatment is lifestyle modification, including dietary changes, weight loss, and limiting alcohol consumption. Patients are educated about the factors that trigger attacks and methods of avoiding them.

In the case of chronic gout with tophi, surgical removal of the nodules may be necessary. Treatment of gout requires an individual approach and often long-term rheumatological care.