Gout

Gout is an inflammation of the joints which occurs due to the deposition of acid in the joints. Gout can principally occur in every joint; however, the metatarsophalangeal joints of the large toes are affected most often. Gout occurs if there is too much uric acid circulating in the blood. Eating habits or kidney disease are the most common reasons for an increase in uric acid in the blood.

Uric acid occurs due to the breakdown of protein in the body. In the event of an increased breakdown or an excretion disorder of uric acid via the urine, there can be an increase in the uric acid in the blood (hyperuricaemia). From a certain concentration, the uric acid begins to crystallise and build up in the joints and in the connective tissue. The consequences of this is acute or chronic inflammation of the joints – gout. Men are affected far more frequently than women. Excess weight, lack of exercise, increased consumption of meat and a certain genetic predisposition are the known risk factors for gout. Gout usually develops slowly following an ongoing increase in uric acid in the blood. This eventually results in an acute case of gout; for example, after a rich meal containing a lot of meat.

A case of gout is characterised by painful inflammation of the joints, often in the main joint of the big toe. The symptoms usually occur suddenly and frequently at night. The affected joint is inflamed, swollen and reddened. If the uric acid concentration remains elevated, chronic gout affecting further joints and the formation of gout nodules (deposition of uric acid crystals) develops over time. This is visible on the feet and the fingers in particular, or also on the earlobes. Chronic gout can also lead to inflammation in the renal pelvis and to the formation of kidney stones.

Gout is diagnosed on the basis of the patient’s medical history, the distinctive symptoms and by measuring the uric acid in the blood.

Gout is treated by alleviating the joint inflammation and reducing the increased urine level. Anti-inflammatory medication and painkillers are used to treat any joint inflammation. The elevated urine level can be lowered with medication which either reduces the formation of uric acid or increases the excretion of uric acid. The treatment is supported with nutritional advice. As a general rule: less meat, fish, offal and alcohol and more water, vegetables and milk products.