Gout

Gout is a complex type of arthritis caused by the accumulation of urate salt crystals inside a joint. When a specific chemical called uric acid, is either produced in large or small quantities (as opposed to the normal quantity) and is excreted into the urine by kidneys, it builds up in your blood forming sharp needle shaped crystals. These crystals can get piled up in a joint stimulating a chemical reaction within and cause inflammation.

Under normal circumstances, uric acid easily dissolves in the blood and is passed out from the body in urine. Uric acid is the breakdown product of genetic material in our body and also of certain foods and drinks. The chemical imbalance occurs when we add an increased amount of foods containing uric acid in our diet. Foods such as steak, liver, shellfish, kidney and drinks like beer or beverages sweetened with fruit sugar contribute to an increase in blood level of uric acid. 

However, diet consisting of the above mentioned items is not necessarily the cause of disease. It can be associated with diabetes, obesity, high blood pressure, certain medications (for example thiazide diuretics), high lipid levels in blood, family history of gout, recent surgery or trauma and age. It is seen more commonly in males above the age of 45 years. Women become more susceptible after menopause.

An attack of gout characteristically involves a single joint. Often, the base of the big toe in one of your feet is the target of the first episode. As the disease progresses, recurrent episodes occur in the same or different joints. The knee or ankle can also be affected. Urate crystals can also lead to uric acid kidney stones. Untreated gout can advance on to the appearance of “Tophi”. These are small lumps, noticed on the feet, back of ankles, hands and fingers, as a result of local crystal concentration.  

When to seek expert advice

Any joint pain, especially if only one joint is bothering you, should be a sign to seek medical advice. When you have an intense episode as described above, make an appointment with a doctor from the Section of Rheumatology.

Do not delay, as it is important for gout to be treated at the earliest. Otherwise, it can cause much damage to your joint. ​