Uric acid is a break down product and is excreted by kidney. In patients with gout body either makes too much uric acid or it cannot excrete it from the body in large enough quantities. Persons who have high level of uric acid in the blood are at high risk of developing gout. Higher the level of uric acid higher the risk of developing gout.
Risk factor for developing gout :
When the uric acid level in the blood is high, it deposits in the joint and causes inflammation in the joint resulting in excruciating pain. Gout most commonly affects the foot, although any joint in the body can get affected. Pain starts as a dull aching pain but soon develops into very severe throbbing pain which may be one of the most sever pain one has ever experienced. Pain of gout usually subsides in 2-3 days and patient can resume normal life. If uric acid levels are not controlled other joints get affected.
Gout if not treated properly can result in kidney stones and result in kidney failure.
Moreover these patients are at higher risk of heart attacks. Uric acid can get deposited beneath the skin resulting in formation of chalky substance called “Tophi”
First priority in a patient who has severe attack of gout is to relieve his pain. For this the best available method is to give intraraticular injections. Other drugs available are NSAIDs, Cochicine etc.
Primary aim of long term management of gout is to decrease the uric acid levels to normal. Weight reduction helps in reducing the uric acid levels in the blood.
Foods like seafood, soft drinks like coco cola/Pepsi , alcohol etc increase the uric acid level in the blood and has to be avoided. Taking lot of milk decreases uric acid level in the blood. Drinking lot of water also can help gout patients by increasing the uric acid excretion. To decrease the uric acid levels like Allopurinol or newer drugs like Febuxostat has to be used in majority of patients with gout. The aim is to keep the level of uric acid below 6.