Gouty Arthritis


RIC acid, one of the body’s waste products, normally passes out through the kidneys in your urine. If there is more of it than the kidneys can process, gout is a likely outcome. Gout is a common form of joint disease in which uric acid accumulates and forms crystals that may become lodged in certain areas of the body. When uric acid crystals are caught in the spaces between one of your joints, the tissue surrounding the joint becomes inflamed and irritates the nerve endings, which causes extreme pain. Crystals also accumulate in the kidneys, which may cause kidney failure.

What are the symptoms?

The main symptom of gout is severe pain, sometimes in your elbow or knee but more often in your hand or foot, frequently at the base of your big toe. The pain usually occurs without warning. Within a few hours your joint is swollen and tender, there is often a low-grade fever and the inflamed skin over the joint is often reddish-purple, shiny, and dry.

Gout affects males more than females after puberty. The first attack usually involves only one joint and last only a few days. Sometimes no more attacks occur, but there is usually a second, which may not come on for months or years. After the second attack, the gout may occur at short intervals, last longer, or involve more joints.

What are the risks?

Gout is one of the most controllable of the metabolic disorders. If untreated, it can lead to joint deformity, death from kidney disease, or high blood pressure.

What should be done?

Even though your first attack will subside on its own in a few days and there will be no immediate recurrence, see your physician. Do not try to ease the pain with aspirin, which slow down the excretion of uric acid. Your physician may advise you to make changes in your eating and drinking habits. A high daily water intake is important in controlling uric acid levels, particularly in the urine where uric acid crystals accumulate to form stones.

What is the treatment?

There are three lines of treatment. The first is to control of pain. The second is control of joint inflammation caused by uric crystals. For these objectives your physician may prescribe a nonsteroidal anti-inflammatory drug (NSAIDs), or colchicines, a drug to reduce joint inflammation.

Since the symptoms may disappear after the first attack, or the disease may be dormant for months or years, your physician may not prescribe any additional drugs at first. If the symptoms recur, however, you may need the third line of treatment, which involves two drugs to control your metabolic problem.

One drug increases the excretion of uric acid, but you won’t receive this drug if tests show you are already excreting large amounts of uric acid. Your physician may recommend that you help this process by increasing your intake of non-alcoholic fluids. The second and most widely used kind of drug reduces the amount of uric acid produced by your body. if you take the drugs exactly as prescribed, the disorder should not occur.

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