Gout is a disorder of uric acid metabolism in the body. These are the symptoms, causes and how to treat gout. With Johns Hopkins Rheumatology

Gout

Medical specialist:	Internal disease
Symptom:	Pain, limited joint movement, swelling
Risk Factors:	High-purine foods, family history
Diagnosis Method:	Medical interview, physical examination; and examination of blood, joint fluid, and urine.
Treatment:	Giving painkillers, anti-inflammatory, or lowering uric acid.
Drug:	Ibuprofen, naproxen, corticosteroids, allopurinol.
Complications:	Widespread inflammation, impaired kidney function, kidney stones.
When to go to the doctor?:	If after taking the medicine the complaints do not improve, do a self-examination to the doctor.

Gout Definition

Gout or in a medical language known as gout is a medical condition where there is a disturbance in the metabolism of uric acid in the body.

As a result, there is an increase in uric acid levels in the body.

Excess uric acid crystals will accumulate in body tissues and cause inflammation (inflammation) in the joints (arthritis).

Chronic (long-term) gout can cause a buildup of uric acid both in and around the joints.

In the end this can reduce kidney function to form kidney stones.

Gout Reason

Uric acid is a waste product that is formed when the body metabolizes substances called purines.

This substance is quite easy to find in some foods and drinks that you often eat, such as alcohol, liver, meat, and seafood.

Gout occurs when uric acid builds up in the body and makes it difficult for the body to excrete it.

When your body produces too much, it builds up to form uric acid crystals.

The buildup can occur around the joints and kidneys. Some of the causes of high uric acid are:

• obesity, high blood pressure, and diabetes
• have a family history of gout
• kidney disorders
• eating foods high in uric acid such as red meat and seafood ;
• consuming too much alcohol

Gout Risk Factor

Increased levels of uric acid in the body is strongly influenced by the food consumed, especially those containing high purines.

These high-purine foods and drinks include:

• Red meat
• seafood
• alcoholic beverages
• innards
• lots of nuts
• melinjo and its preparations (emping)
• green vegetables that have been boiled too long

In addition to food and drink, family history and comorbidities can also increase the risk of an increase in uric acid in the body, such as:

• family history of gout
• obesity
• diabetes
• kidney function disorders

Gout Symptom

Symptoms of gout that are generally felt by sufferers are usually in the form of inflammation of the joints and are most often found in the big toe.

These symptoms are:

• hot
• redness
• painful
• limited joint movement
• swelling in the joints

In addition to the big toe, the joints that often experience attacks are other small joints, the ankles, knees, wrists, fingers, and elbows.

In acute attacks, fever and severe joint pain may occur, which usually lasts for hours to days.

Over time, gout attacks will occur more often and last longer.

Uric acid crystals can form tophi (hard but painless lumps around the joint) outside the joint.

Tophi are often found around the fingers as well as at the tips of the elbows and around the big toes.

In addition, tophi can also be found on the earlobe, the Achilles tendon (the area behind the ankle), and the vocal cords (very rarely).

Gout Diagnosis

Here are some steps that doctors usually do to diagnose gout.

• History

As with the establishment of other diseases, the first thing to do in a medical interview or anamnesis.

It is very important to dig deeper into the complaints experienced by the patient, such as since when, the location of the complaint, the characteristics of the pain, the triggering factors and symptom relief, the duration of the pain, and the severity of the pain.

The criteria for suspecting gout are the appearance of rapid pain and joint inflammation.

This inflammation can move from one joint to another, especially in the big toe joint. Complaints of pain will usually disappear after the attack.

• Physical examination

After taking the history, a physical examination will be performed to directly assess the location of the joint pain experienced and assess its severity.

• Blood Check

Blood tests will be carried out to assess whether there is an increase in uric acid levels in the blood.

If there is a suspicion of complications, kidney function tests and other support will also be carried out.

• Radiological Examination

Although rarely performed to confirm the diagnosis, radiological examinations such as X-rays can be performed to rule out other possible diagnoses.

• Joint Fluid Examination

Another examination that can be done is an examination of the fluid around the joints ( synovial fluid ).

The purpose of this examination is to find the presence of uric acid crystals.

• Urine Examination

Another test that can be done is a urine test.

Through this examination, it can be ascertained if there is an increase in uric acid and uric acid crystals.

Gout Treatment

Keep in mind, gout cannot be cured. However, this condition can be controlled with medication.

Complaints felt by gout sufferers will usually disappear within 24 hours after starting treatment.

Here are some ways to treat gout.

• Pain relief

Treatment of gout is generally done with anti-inflammatory drugs class NSAIDs, such as ibuprofen or naproxen.

This gout drug is generally given to treat severe and sudden attacks to reduce inflammation and pain.

• Anti-inflammatory

For gout sufferers who can not use NSAIDs will be given corticosteroids, steroids that work to reduce inflammation.

Steroids can be injected (injected) directly into the affected joint or taken by mouth in pill form.

• Uric Acid Lowering

After the acute attack condition or pain is handled properly, efforts will be made to control the level of uric acid in the blood.

Usually, the doctor will prescribe allopurinol which must be consumed regularly.

Gout Prevention

The way you can do to prevent gout is to make lifestyle changes to be healthier.

You can increase the consumption of foods with balanced nutrition and high fiber. Remember to drink enough water and exercise regularly.

In addition, no less important avoid the consumption of foods high in purines.

Complications

• Widespread Inflammation

If the condition of an acute attack cannot be managed properly, inflammation in the joints can become severe and widespread.

• Kidney Function Disorder

Untreated uric acid levels in the blood can aggravate kidney function.

• Kidney stones

High levels of uric acid in the blood can increase the risk of developing uric acid stones in the kidneys.

When to go to the doctor?

When an acute attack, it is advisable to take painkillers and anti-inflammatory drugs to deal with the pain and inflammation experienced.

After that, you can take medication to help control uric acid levels in the blood.

If the complaint does not improve, it is highly recommended to conduct a self-examination to the doctor for clinical evaluation and further management.

For an initial examination, you can consult a general practitioner.

However, if the condition is severe enough, further examination can be carried out by an internal medicine specialist.

If necessary, the patient will be referred to an orthopedic specialist.