Gout can have many different factors and here are a few different reasons:

• An elevated serum urate concentration
• Recurrent attacks of acute arthritis in which Monosodium Urate (MSU) crystals are in synovial fluid
• Aggregates of MSU crystals (tophi) deposited in & around joints leading to deformity & crippling
• Renal disease involving glomerular, tubular, interstitial tissue & blood vessels or kidney failure
• Uric acid nephrolithiasis or kidney stones

Gout: Who are affected?

Typically, gout patients are about 95% men, 5% women.

• Gout is nine times more common in men than in women
• It predominantly attacks males after puberty, with a peak age of 75. In women, gout attacks usually occur after menopause.

Gout: What are the causes?

When the level of Uric Acid increases, due to the inability of kidneys to pass it off to bladder, it starts accumulating in the blood in different parts of body like joints, knees, etc. This excess amount of uric acid forms tiny thin crystals in different parts of body especially in the joints, ankles, etc.

• Obesity, excessive weight gain (especially in youth),
• Moderate to heavy alcohol intake
• High blood pressure
• Unhealthy eating habit, especially junk food
• High protein-rich food
• Fructose in corn syrup found in soft drinks
• Abnormal kidney function.
• Nose or throat disease
• Heredity or genetic causes
• People who does not wear comfortable shoes and in improper way suffer from gouts. In patients at risk of developing gout, certain conditions can precipitate acute attacks of gout. These conditions include:
• Dehydration
• Injury to the joint
• Fever
• Recent surgery
• Certain drugs, such as thiazide diuretics (hydrochlorothiazide [Dyazide]), low-dose aspirin, niacin, cyclosporine, tuberculosis medications (pyrazinamide and ethambutol), and others can cause elevated uric acid levels in the blood and lead to gout.
• Certain diseases lead to excessive production of uric acid in the body. Examples of these diseases include leukemia, lymphomas, and hemoglobin disorders.

Gout: What are the symptoms?

• Severe pain in joints, knees, toe, etc. followed by warmth, swelling, reddish discoloration, and marked tenderness.
• Gout generally, attacks patient late night or early morning.
• The small joint at the base of the big toe is the most common site of an acute gout attack of arthritis (podagra)
• Tenderness can be intense so that even a blanket touching the skin over the affected joint can be unbearable.
• Patients can develop fever with the acute gout attacks.
• These painful attacks usually subside in hours to days, with or without medication. In rare instances, an attack can last for weeks.
• Most patients with gout will experience repeated attacks of arthritis over the years.
• Other symptoms include, loss of appetite and sleep, also suffer from kidney stone. In acute cases, kidney sometimes completely fails.

Gout: How to diagnose?

• The most reliable test for gout is finding uric acid crystals in a sample of the joint fluid obtained by joint aspiration (arthrocentesis).

X-rays can sometimes be helpful and may show tophi-crystal deposits and bone damage because of repeated bouts of inflammation. X-rays can also be helpful for monitoring the effects of chronic gout on the joints.

Gout: What are the treatments?

There are two key concepts essential to treating gout. First, it is critical to stop the acute inflammation of joints affected by gouty arthritis. Second, it is important to address the long-term management of the disease in order to prevent future gouty arthritis attacks and shrink gouty tophi crystal deposits in the tissues. The treatment of an acute attack of gouty arthritis involves measures and medications that reduce inflammation. Preventing future acute gout attacks is equally as important as treating the acute arthritis. Prevention of acute gout involves maintaining adequate fluid intake, weight reduction, dietary changes, reduction in alcohol consumption, and medications to lower the uric acid level in the blood (reduce hyperuricemia).

Gout: How can it be prevented?

• Prevention of gout includes maintaining adequate fluid intake and reducing alcohol consumption. Alcohol has two major effects that worsen gout by impeding (slowing down) the excretion of uric acid from the kidneys as well as by causing dehydration, both of which contribute to the precipitation of uric acid crystals in the joints • Additional prevention methods include weight reduction and dietary changes.
• Weight reduction can be helpful in lowering the risk of recurrent attacks of gout. This is best accomplished by reducing dietary fat and calorie intake, combined with a regular aerobic exercise program.
• Medical treatment includes pain relievers such as Tylenol, anti-inflammatory medicines, and other medicines specific for gout medications.

Gout: How can diet help?

Dietary changes can help reduce uric acid levels in the blood. Meat or seafood consumption increases the risk of gout attacks; while dairy food consumption seemed to reduce the risk. Balance diet is very important to keep a healthy body

. • Patient suffering from gout should survive on orange juice for a week. During this period, orange juice diluted in water 2-3 times a day is suggested.

• Once this period is over, patient should slowly start having other fruits like apple, banana, etc.
• Once patient start showing improvement, he/she should be given proper balanced diet rich in green vegetables, fruits, whole wheat grain, etc.
• Junk foods, protein-rich food like mutton, egg, etc. should be avoided.
• Purine-rich foods should be avoided. Examples of foods rich in purines include shellfish and organ meats such as liver, brains, kidneys, and sweetbreads.