Gout. A rich man's disease? Read on if you think this is still true.

                                                         GOUT

 

A rich man's disease? 

Afraid not..........

Gout affects around 1–2% of the Western population at some point in their life. Rates of gout have approximately doubled between 1990 and 2014. 

This rise is believed due to increasing life expectancy, changes in diet, and an increase in diseases associated with gout, such as metabolic syndrome and hypertension. A number of factors have been found to influence rates of gout, including age, race, and the season of the year. In men over the age of 30 and women over the age of 50. 

Gout is a disorder of purine metabolism, in english that means that uric acid crystallizes in the form of monosodium urate, precipitating in joints, on tendons, and in the surrounding tissues. 

The triggers for precipitation of uric acid are not well understood.  Other factors believed important in triggering an acute episode of arthritis include cool temperatures, rapid changes in uric acid levels proteins. 

The increased precipitation at low temperatures partly explains why the joints in the feet are most commonly affected. Rapid changes in uric acid may occur due to a number of factors, including trauma, surgery, chemotherapy, diuretics, and stopping or starting allopurinol. Calcium channel blockers  and Lorsartin are associated with a lower risk of gout as compared to other medications for Hypertension.

       Gout may be diagnosed and treated without further     investigations in someone with hyperuricemia (high uric acid    levels). This is normally determined by a simple blood test. Synovial fluid analysis can be carried out if the diagnosis is in doubt. 

Xrays can be useful for identifying chronic gout, but have little use in acute attacks. 

Treatment 

The initial aim of treatment is to settle the symptoms of an acute attack. Repeated attacks can be prevented by different drugs used to reduce the serum uric acid levels. Ice or cold compress applied for 20 to 30 minutes several times a day decreases pain. Options for acute treatment include (NSAIDs), colchicine and steroids. 

Options for prevention include allopurinol lowering uric acid levels which can cure the disease.

PSEUDO- GOUT is a joint problem is caused by pyrophosphate, a calcium salt which is different from uric acid. This may be one of the most misunderstood forms of arthritis. Joint problems seen with these crystals often are mistaken for gout and other conditions.