Gout causes sudden and severe attacks of pain and hypersensitivity, redness, warmth and swelling in some joints. Generally it commits one joint at a time. The joint of the big toe is usually the first.
What is the cause?
- Most people who suffer from gout have elevated levels of a body waste product called uric acid in the blood (hyperuricemia). Uric acid forms crystals that deposit in the joints and produce inflammation. However, not all people who have hyperuricemia have or will develop gout.
- Uric acid is a substance that is normally formed when the body breaks down waste products called purines.
- Gout can be hereditary or it can present as a complication of another condition.
- Diet, weight and alcohol consumption can also play an important role in gout and hyperuricemia.
What are the symptoms?
Episodes develop very quickly; The first episode usually happens during the night.
Episodes may be caused by:
- Joint trauma
- Excessive alcohol intake
- Excess consumption of certain foods
- Surgery
- Severe and sudden illness
- Aggressive diets
- Certain diuretic medications
- Chemotherapy
How is it diagnosed?
- Physical examination and clinical history.
- Blood tests to measure uric acid levels.
- Analysis of joint fluid to verify the presence of uric acid crystals.
Treatment options
Treatments may include:
- Diet
- Weight control
- Restriction of high purine content foods
Relative Content of Purine in Common Foods
Group A: foods containing high levels of purine concentration, approximately 150 to 1,000 mg per 100 grams (try to avoid these foods).
| Liver | Sweetbread (viscera) |
| Sauces | Anchovies |
| Broths | Mussels |
| Brains | Roe (fish) |
| Wine | Beer |
| Kidney | Sardines |
| Heart | Herring |
Group B: foods containing moderate levels of purine, 50 to 150 mg per 100 grams, which doctors usually restrict to one serving per day.
| meats | Mushrooms |
| Peas (peas or peas) | Spinach |
| Cauliflower | Lentils |
| Asparagus | Broad beans |
| Chicken | Yeast |
| Whole grains | |
| Fish (except those mentioned above) | |
| Other seafood | |
Group C: foods that contain insignificant levels of purine. These do not affect gout.
| Fruits | Nuts |
| Milk | Sugar and sweets |
| cheese | Eggs |
| Chicken | Yeast |
| Vegetables (except those mentioned above) | |
| Spices and condiments, including salt and vinegar | |
| Refined cereals and cereal products | |
| Butter and fats (in moderation) | |
| Vegetable soups (light) | |
- Avoid alcohol consumption
- Drink 10 to 12 eight-ounce glasses (250 ml) of soft drinks (eg water) per day
Medications to relieve pain and swelling during an acute attack:
- NSAIDs COX-2 inhibitors
- GlucocorticoidsACTH (adrenocorticotropic hormone)
- Colchicine (available only as a generic drug)
Medications to prevent further episodes:
Colchicine
Medications to control uric acid levels:
- Allopurinol
- Probenecid
- Sulfinpyrazone
- Febuxostat
- Pegloticase
- Selective inhibitor of uric acid reabsorption (ISRU): lesinurad ( Zurampic )
- Surgery (rare)
Who is at risk?
- It mainly affects men over 40 years of age, but it can affect people of any age.
- Women with gout usually develop after menopause.
Doctors have observed a relationship between psoriasis, psoriatic arthritis and gout for decades. The common denominator is to present high levels of uric acid. It is also suspected that this can increase your risk of kidney problems, diabetes, cardiovascular disease, apnea and cancer.