What is gout;

'Gout is the most common form of inflammatory arthritis. It occurs when there is too much uric acid in the bloodstream.'

Uric acid is produced by the breakdown of purines, which are found in the foods we eat.

The kidneys help filter uric acid, which is then excreted from our bodies through urine. When the kidneys are unable to filter or process uric acid levels at the same rate as they are created, this can cause high levels of uric acid to remain in the bloodstream.

Genetics play a significant role in those at risk for gout. Even if two people have the exact same diet and eating habits, one person could have higher levels of uric acid in their bloodstream and be at increased risk of developing gout.

Uric acid crystals are usually found under the skin and form hard, chalky white lumps. When present, these crystal deposits (tophae) can usually be seen around the ears and around the extensor tendons, which are found in the hands and feet. Uric acid crystals in the joints can be responsible for gout attacks.

What are the early signs and symptoms of gout? 

Gout attacks, especially early ones, can come on suddenly, but this is often the result of months or even years of uric acid levels building up in the bloodstream. After a long period of prolonged high uric acid levels (usually above 6.8 mg/dl), it can begin to leave the bloodstream and begin to form crystals in soft tissues and joints (the most common are the joints of the lower extremities such as the knees, ankles and especially the base of the big toe).

Attacks are often triggered by the immune system, which responds to the uric acid crystals that have formed in the joints and soft tissues. When immune cells enter the joint to try to eliminate the uric acid crystal, inflammation, redness, pain and swelling will occur, causing what is known as a gout attack.

Many people will have no idea they have gout before the first attack occurs.

Other risk factors include infection, a sharp increase in uric acid levels in the bloodstream, for example after a high-protein meal, a night of drinking alcohol (especially beer), or a period of dehydration.

Why is treatment for gout so important?

Gout attacks tend to increase in duration and frequency without treatment and can even become chronic. The continued presence of uric acid crystals in and around the joint can lead to destruction of the joint and the soft tissues around it.

Fortunately, with proper medical care and treatment, few patients progress to this advanced stage. Most people living with chronic gout can control the condition with medication. Lifestyle changes are an important part of treatment and can help prevent and manage flare-ups. Early recognition and treatment can reduce the chance of permanent joint damage and the number and severity of attacks.

How is gout treated?

Treatment of gout consists of three main steps:

Step 1: Treating the active gout attack.
Step 2: Reducing uric acid levels in the bloodstream.
Step 3: Prophylactic medication to reduce uric acid.

During an attack, the joint needs rest, elevation of the limb, and ice therapy. It is important to start medication early (in consultation with your doctor). Finally, drink plenty of water and fluids and avoid alcohol and sugary drinks.