Gout Introduction

Alpha Health Education

Topics from the

Book of Arthritis

Uric Acid

Allopurinol

Probenecid

Drug Treatment

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Gout occurs acutely as intermittent attacks of inflammatory arthritis with severe joint pain, swelling, redness and warmth of affected joint. In some individuals, it can be a progressive, crippling chronic disease that also damages the kidneys. Gout affects more than one million Canadians and Americans. Painful attacks of joint pain can occur at any age, but the first attack often affects men between the ages of 40 and 50. Gout is 20 times commoner in men than women; however, the number of postmenopausal women who have gout is increasing. Obesity, high blood pressure and atherosclerotic heart disease are often associated. A familial pattern is observed in up to15% of cases.

Attacks of gout develop quickly. The first attack often occurs at night. You wake up with severe joint pain and a red, swollen, hot joint. Early on, arthritic attacks last only a week or so with no symptoms between episodes. Attacks occur infrequently at first - months apart - and may increase in frequency and severity as the uric acid problem increases. Repeated episodes can damage the affected joint. In 90% of initial episodes, a single joint is involved--especially the joint at the base of the big toe. The foot, heel, ankle, knee, hands, wrists and elbows are the other joints that are frequently involved.

Gout occurs when there is too much uric acid in the blood, a condition called hyperuricemia,  caused by two factors :

  • The kidneys can't get rid of uric acid fast enough.

  • The body makes too much uric acid.

Hyperuricemia may be caused by diuretic medications. Diuretics are used to treat high blood pressure and edema by increasing kidney water and sodium excretion. Diuretics decrease the kidneys' ability to remove uric acid, thus raising uric acid levels in the blood. Other factors, such as inherited traits and environmental factors (excess weight, alcohol use and poor diet) can play a role in causing gout.

A Gout attack is a severe inflammatory arthritis usually in one joint; the characteristics are

  • severe joint pain and swelling

  • red or purple skin around the joint

  • extreme tenderness -the area may be so tender that even the touch of a bed sheet may cause severe pain.

An episode of gout can be triggered by:

  • drinking alcohol

  • eating the wrong foods - high protein, high purine foods

  • Diuretic drugs

  • injury to a joint

  • chemotherapy