Gout is probably one of the oldest recognised forms of arthritis it was described by Hippocrates who noted amongst other things that "eunuchs neither get gout nor grow bald". It is also described as the king of diseases and disease of Kings. Gout is much more common in men then women who as Hippocrates also pointed out, are rarely affected before the menopause. It would seem that gout tends to affect those with a more affluent life style. It has also been said that sufferers from gout are often of more than average intelligence.
Gout is caused by a build up of uric acid in the blood. Uric acid is a normal breakdown product of various chemical processes within the body. The build up of uric acid is caused by a defect in the way the body deals with uric acid, this defect is usually inherited.
When uric acid builds up it sometimes forms crystals in the joints which then become hot red and painful.
It is not true that eating and drinking causes gout however if you do over indulge it may make attacks of gout more likely.
Acute gout is one of the most painful forms of arthritis. Attacks usually start during the night and most often affect the big toe which becomes red swollen and extremely tender, sometimes resembling a boil.
Other joints may be affected for example wrists knees and elbows. Excess uric acid also sometimes forms deposits in the skin and may occasionally be responsible for kidney stones.
An acute attack is often triggered by a minor injury to the joint. Excessive eating and drinking may also precipitate an attack in those with a tendency to gout.
Gout is usually diagnosed by your doctor from the history and appearance of the affected joint. Blood tests may help to support the diagnosis but a raised uric acid may be found in people who do not have gout. Finding crystals of uric acid in the joint will prove the diagnosis, however this involves sticking a needle into the joint to remove fluid. X-rays tend not to be very helpful as the are usually normal.
Acute attacks of gout are usually treated with non-steroidal anti-inflammatory drugs that both relieve pain and reduce inflammation. Aspirin should be avoided as it may make an attack worse.
If acute attacks recur, regular preventive treatment with a drug called allopurinol may be required this drug reduces uric acid levels but needs to be taken continuously for life.
With effective treatment most sufferers can eat a normal diet. However certain foods contain high levels of purine which contributes to high serum uric acid levels, these include liver, kidney, anchovies, sardines, mussels, herring, bacon, scallops, trout, haddock, veal, venison, and turkey. Alcohol whilst not causing gout may precipitate an attack.
This article published on
28 November 2005
Next review date 01/11/2013
Legs, knees, ankles, feet