Gout is a common type of arthritis that causes intense pain, swelling and stiffness in joints due to the formation of uric acid crystals in the joints causing inflammation.   It is common in older men although it can affect women after menopause.  Family history, cardiovascular or kidney disease and obesity are risk factors for developing gout.  A sedentary lifestyle with purine-rich foods like shellfish or liver and alcohol is associated with gout.

Symptoms

The pain starts suddenly with intense pain which can take between 3-10 days to get better.  The flare up can be triggered by alcohol, stress, change in weather as well as foods like shellfish, offal, kidney, red meat, liver, anchovies or sardines and beans. 

• The joint of the big toe is the most common joint affected with swelling and redness
• The pain can occur anytime including in the middle of the night
• If left untreated, the joint can be come stiff
• In severe cases, you may develop kidney stones

Diagnosis

• Blood tests (usually showed elevated uric acid)
• X-ray or ultrasound of the joint (sometimes required)
• Joint fluid aspiration (sometimes required)

Treatment Options

The management of gout is to provide relief for the pain and medication to prevent future recurrences.  At the same time, the patient is strongly advised to modify the diet and lifestyle to reduce the risk of gout.  Stay hydrated and drink non-sweetened drinks like plain water

• Pain relief using NSAIDs
• Gout medication which block uric acid production (Allopurinol & Febuxostat) or which increases uric acid excretion (Probenecid & Lesinurad)
• Low dose Colchicine may be used to prevent flare-ups
• Steroid joint injection (for severe cases)

Remember to keep your follow-up appointments and do your blood tests regularly to help keep your disease in remission

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