Gout is a disease created from excessive amounts of uric acid in the blood. These excessive amounts crystallize within various joints in the body. This condition is the result of under excretion of uric acid (hence urine) by the kidney, overproduction of uric acid in the liver, or a combination of both. There are a number of factors which increases the concentration of uric acid in the blood. They include red meats, alcohol, rich food, and stress. Red wine versus white wine tends to have a higher incidence due to the tannic acids it contains. Stress involving financial, social, employment, or family related situations are also included. Acute attacks are crippling. Of all acute gouty attacks, the great toe is affected in 65% of the cases. Even a bed sheet on the toe can produce excruciating pain. The joint becomes red, swollen, and painful. Usually only one joint is affected at a time.
Treatment includes removing the factors which help create the condition, cortisone injections, and oral medication. Medication available is for both acute and chronic conditions. Tests to diagnose hyperuricemia (elevated blood levels of uric acid) and gout include blood tests, x/rays, aspirating fluid from the joint, and clinical evaluation. Blood test alone does not confirm the diagnosis. It is used as an indicator. Some individuals have increased uric acid in their blood without a gouty attack. This is why elevated levels of uric acid in itself is not a convincing result. One of the problems associated with its diagnosis is the differentiation between Gout and an infection. Evaluating the joint fluid under a microscope is the most definitive method. Therapeutic treatments may assist in its diagnosis. A course of medication of Probenicid, Colchicine, or Indomethasine may rapidly provide relief. With rapid relief (a matter of hours or one day) a diagnosis may be made.
