Gout is a metabolic bone disorder in which a protein metabolism is altered and uric acid accumulates. It develops because of underexcretion or overproduction of uric acid in the body. The initial stage occurs in the third or fourth decade of life and 95% of all cases affect men.
Gout may be an inherent or acquired condition. In an acquired condition, it may develop from the rapid induction of chemotherapy or radiation therapy when there is massive destruction of cells. Renal disorders that decrease the excretion of uric acid may also lead to this disease. Frequent medications of aspirin, mercurial diuretics or anti-tuberculosis drugs may trigger this metabolic disorder. Alcohol intoxication or ingestion may either increase or decrease uric acid excretion. Uric acid can accumulate in your blood, kidney or ears among others. Upon reaching a certain level, this acid crystallizes and the crystals called tophi are deposited in connective tissue. This is then classified as a form of arthritis.
An acute attack of gout is accompanied by redness, swelling and exquisite tenderness in one joint like toes, fingers, wrists or ankles. The big toe is the most common site. This first attack develops quickly, often overnight, and may be accompanied by fever, malaise and anorexia. It usually subsides within a week and you may notice local desquamation or tissue loss. After the initial attack, the affected joint returns to normal and you may be asymptomatic for years.
In its chronic stage, permanent changes in multiple joints with restrictions in movement will be noticed. Tophi may be detected on the ears, hands, elbows, feet and knees. Renal and cardiac disorders may also develop. Long-term medication is advised if you have more than two attacks in a year. Clinical manifestations develop in stages
Gradual weight loss is encouraged after the initial attack. A sudden weight loss should be avoided because it may precipitate an attack due to the destruction of cells which release uric acid.
Opinions differ regarding dietary treatment for gout. You may abstain from red and organ meats or you may take your usual dietary needs. You are also encouraged to take an ample amount of fluid intake (2000 to 3000 ml/day) to promote excretion of the uric acid. A moderate intake of alcohol in distilled forms is preferred to excessive alcohol intake, while beer, ale and wine may start gout attacks. Get plenty of exercise to produce sweat and remove toxins from your body. Include a lot of fruits and vegetables in your diet.
If you can recognize early symptoms of this disease, then you may be able to avert the attack by prompt use of prescribed drugs. You must also be aware of the long-term side effects of these agents like bone marrow suppression.
Pain management includes bed rest. Once you are capable of movement again, consider your need for crutches or a walker until you can amble along steadily. Know your dietary restrictions, fluid requirements and self-management once you already have this disorder.