Gout usually affects only one or two joints at a time. The first attack of gout usually will disappear on its own after about a week but will eventually return in a matter of months or even years. Gout will get progressively worse without treatment, attacking more and more frequently and severely and involving more joints until a chronic condition of gout occurs.

Chronic gout causes damage to the joints, crippling and disability. Gout is very rare in pre-menopausal women, but, after menopause, it is common in women. Gout affects more men than women and it has been reported by 10 percent of adult men in some surveys.

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What are the Symptoms of Gout?
The symptoms of gout include severe joint pain and inflammation, normally in only one or two joints, most commonly in the ankle or the ball of the large toe. Gout comes on suddenly, and causes such severe pain when the joint is moved or touched that even so much as a light bed sheet over it causes pain. Rarely, the condition may develop in to or three joints at a time but if symptoms occur in several joints at once, the symptoms are probably is due to a condition other than gout.

What Causes Gout?
Gout is caused by microscopic crystals of uric acid which form in the joint and cause inflammation of the joint. Uric acid is a chemical that is produced in the body and plays an important role in breaking down food and building tissues in the body. The uric acid, when at normal levels, will dissolve in the blood and be excreted in the urine.

However, when the levels of uric acid are elevated, a condition called hyperuricaemia, the uric acid forms crystals which deposit themselves in the joint and cause the inflammation and pain of gout called acute gouty arthritis or acute gout. The most common site for the deposit of these crystals is the first metatarsal phalangeal joint of the big toe or the joint of the ankle.

The elevated levels of uric acid which cause gout can be caused by several different factors. Obesity, consuming large amounts of alcohol, eating large amounts of purine containing foods, genetics, some high blood pressure medications and, less frequently, long-term kidney disease may cause elevated levels of uric acid in the blood.

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How is Gout Diagnosed?
Gout is diagnosed by extracting some fluid from the affected joint with a needle and looking at it under a polarized light microscope to check for uric acid crystals. This invasive test is a very reliable method to gain a quick, accurate diagnosis. Once a diagnosis of gout is made, the proper treatment can begin and the quicker the patient will start to feel better.

What is the Treatment for Gout?
Gout is treated by first remedying the problem of elevated levels of uric acid in the blood. Because the elevated levels of uric acid cause the crystals to form in the joint which leads to an acute attack of gout, lowering the levels of uric acid in the blood will prevent future acute attacks of gout.

One of the ways of lowering uric acid in the blood, and, thereby, preventing an attack of gout, is to limit the intake of certain foods which contain Purines such as red meat, scallops, fish , peas, lentils, beans and shellfish. In addition, the patient with gout should limit alcoholic beverages to two per day except on rare occasions. If it is the medication for high blood pressure that is causing gout, the medications should be changed. Furthermore, if the patient with gout is overweight, he will want to loose weight because obesity contributes to high uric acid levels.

The lifestyle changes necessary for the treatment of gout require the cooperation of the patient. Unfortunately, weight loss is not easy for many people. Neither is giving up on favorite foods or alcohol. Often, the gout will have to be very bothersome and occur quite frequently before a patient agrees to make major changes in their lifestyle.

Many patients continue to indulge in rich food and alcohol and continue to suffer from these attacks of gout. There are some medications to treat attacks of gout. Colchicine is used for acute gout attacks and probenecid and allopurinol are used for long term gout.

Gout can be treated with medication, but it takes the cooperation of the patient to change his lifestyle which will prevent joint damage caused by elevated levels of uric acid in the blood. If uric acid levels are not lowered, movement may be severely and unnecessarily inhibited.

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