Gout is one of the oldest diseases recorded in medical history. It is an inherited disorder of purine metabolism in which abnormal levels of uric acid accumulate in the blood. This leads to the formation of sodium urates which are deposited as tophi in the small joints and surrounding tissue especially in the cartilage of the ear. These deposits can destroy joint tissue and lead to chronic arthritis.

 

  • The disease usually occurs after 35 years.
  • It is characterized by arthritic pain which is often localized in a sudden attack that begins in the big toe and continues up the leg.
  • Small injuries or unaccustomed exercise may cause episodes of pain.
  • Attacks have been related to excessive eating, drinking and exercise
  • Obesity is commonly associated with gout.
  • The excess of urates also damage the kidneys and kidney stones may form.

Diet and Gout

 

  • Uric acid is derived from the metabolism of purines which are part of nucleoproteins.
  • Traditionally gout has been treated with a low purine diet but drugs have now largely replaced the need for low purine diets.
  • Although limiting dietary purines does not significantly reduce the uric acid pool, individuals with gout are encouraged to restrict or avoid foods high in purine.
  • Urate excretion tends to be reduced by fat and enhanced by carbohydrates therefore the diet should be relatively high in carbohydrate, moderate in protein and low in fat.

Alcohol and Gout

 

  • It is now believed that moderate use of alcohol by individuals with gout does not induce an acute attack.
  • As alcohol does increase uric acid production, individuals are advised not to consume alcohol on a regular basis.
  • Moderate, infrequent consumption may not be harmful.

Drug therapy

 

  • Gout is treated with drugs that increase the excretion of urates or that inhibit the synthesis of uric acid.
  • Anti-inflammatory agents are frequently used in the acute stage.

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