Gout treatment in Pune
What is Gout?
Gout: Causes, Symptoms, Diagnosis, and Effective Gout Treatment in Pune
Gout is a painful inflammatory arthritis caused by the deposition of uric acid in the joint. It usually occurs in a single joint, especially the joint at the base of the big toe, although it may occur in other joints and may involve more than one joint.
Gout is very common in young males. Gout rarely occurs in children and young women. Young females usually do not suffer from gout as estrogen is uricosuric, and females will suffer from gout only after menopause. For those looking for Gout treatment in Pune, consulting an experienced rheumatologist is essential.
What is Uric Acid?
Uric acid is a breakdown product of purines that are part of many foods. Purines are found in high concentration in meat and meat products, especially internal organs like the liver and kidneys. Being a breakdown product, uric acid is naturally present in the body. However, when it accumulates in the blood in excessive amounts (known as hyperuricemia), it has a tendency to precipitate in joints
Clinical Features of Gout:
- Asymptomatic Hyperuricemia
Many people may have raised levels of uric acid in their blood without any joint pain. - Acute Gout
Sudden onset of severe pain and swelling of the involved joint, most often the joint at the base of the big toe. Other joints like ankles, knees, elbows, wrists, and hand joints can also be affected.
The affected joint becomes swollen, tender, warm, and red. Pain is most severe in the first 12 hours and decreases over a week. Later attacks may last longer and affect more joints. - Intercritical Gout
The interval between two gouty attacks is called intercritical gout. The patient remains asymptomatic during this phase. Without diet control, lifestyle modification, or medication, most patients experience a second episode of arthritis within two years. - Chronic Tophaceous Gout
If recurrent acute gout and hyperuricemia go untreated, the condition may progress to recurrent polyarthritis, persistent low-grade joint inflammation, joint deformity, and deposition of uric acid crystals forming visible tophi.
Tophi are nodular masses of white chalky paste-like material containing uric acid crystals. Tophi develop around the joints of the feet, fingers, elbows, Achilles tendon, and ear.
Risk factors for Gout :
- Male gender
- Age < 40 years
- Obesity
- Family history
- Alcohol use and purine rich foods.
- Renal insufficiency
Diagnosis of Gout :
A rheumatologist will suspect gout when a patient presents with episodic joint pain, swelling, redness, and warmth, particularly in the big toe. Serum uric acid levels are checked, but they may be normal during an acute attack. Hence, a normal uric acid level does not rule out gout, and a high uric acid level does not confirm it. If a large joint is swollen, synovial fluid can be aspirated and examined under a polarized light microscope. The presence of needle-shaped birefringent crystals confirms gout. However, the absence of crystals does not rule out the diagnosis. To prevent long-term complications of Gout, timely diagnosis is crucial.
If the joint involved is a large and swollen joint synovial fluid from the joint can be aspirated and examined under a polarized light microscope. Demonstration of needle-shaped birefringent crystals in the synovial fluid is considered as gold standard for diagnosis of gout. But this may not be possible always and the absence of crystals will not rule out diagnosis.
Treatment of Gout :
Goals of Treatment:
- Relieve pain and restore joint function quickly
- Prevent recurrence of acute gouty arthritis
- Prevent complications due to uric acid crystal deposition
- Correct contributory factors like obesity, dyslipidemia, or hypertension
Treatment of Asymptomatic Hyperuricemia:
High uric acid levels without symptoms do not require urate-lowering therapy. Instead, identifying and correcting the underlying cause often normalizes uric acid levels. Certain medications, such as low-dose aspirin, diuretics, and tuberculosis drugs (pyrazinamide, ethambutol), may contribute to high uric acid levels.
2. Treatment of Acute Gout:
- Acute gout attacks can be treated with:
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
- Colchicine
- Steroids
Urate-lowering therapy should not be started during an acute attack as it can worsen symptoms.
Treatment of Chronic Gout:
Long-term gout treatment focuses on lowering uric acid levels. Medications like Febuxostat and Allopurinol are widely used. The goal is to maintain uric acid levels below 6 mg/dL. Urate-lowering therapy is recommended for patients with:
- Two or more gout attacks per year
- One or more tophi on clinical examination or imaging
If you’re looking for the Best Gout treatment in Pune, specialized care is available.
Diet and Gout:
Excess uric acid can result from consuming purine-rich foods. Avoiding high-purine foods can help manage gout effectively.
Foods to Avoid:
- Organ Meat: Liver, kidneys, and brain are rich in purines.
- Red Meat: Should be avoided as it is high in purines.
- Seafood: Anchovies, sardines, and tuna increase uric acid levels.
- Alcohol: Beer and distilled liquors raise the risk of gout.
- Sugary Foods and Beverages: Sweets, fruit juices, soda, and soft drinks elevate uric acid levels.
Foods to Include:
- Vegetables & Fruits: Vegetables are generally protective, though purine-rich ones like peas, beans, spinach, and mushrooms should be consumed in moderation. Vitamin C-rich fruits like oranges and grapes help lower uric acid levels.
- Dairy Products: Milk and curd do not raise uric acid levels and can be safely consumed.
- Water: Drinking plenty of water helps flush excess uric acid from the body.
For professional Gout treatment in Pune, consult a rheumatologist for proper diagnosis and management.