Diagnosis and Prevention of Gout

Gout is a common medical disorder and diagnosis of gout is not difficult. For diagnosis of gout, blood tests are usually sufficient. However, sometimes synovial fluid (the fluid present inside the joint space) analysis and X-ray may be required for diagnosis, when there is doubt in diagnosis. Most of the cases can be treated by doing blood tests alone.

Blood tests:

In most of the cases of gout, hyperuricemia or high blood/serum uric acid level is a feature. However, in large number of cases there may not be any rise in blood uric acid level with gout and many individuals with hyperuricemia, never develop gout. Here lies the problem of diagnosis and treatment of gout and diagnosis of gout can not be made solely based on hyperuricemia. Hyperuricemia is defined when serum uric acid level is more than 7 mg/dl in males and more than 6 mg/dl in females. Other blood tests that may be asked by your doctor include ESR (erythrocyte sedimentation rate), white blood cell count, renal function test etc. Rise in white cell count is generally seen in patients with gout.

Synovial fluid test:

This is done to find out presence of monosodium urate crystals. Presence of which can be taken as diagnostic of gout. This test is difficult and need expert supervision.

X-ray:

Help of X-ray may be required sometimes to diagnose gout. X-ray can detect soft tissue swelling and uric acid crystals.

Prevention of gout:

Gout is caused by multifactorial causes and prevention may not be possible. The aim of prevention should be development of gout in patients with hyperuricemia. Approximately 0.5% to 4.5% patients with hyperuricemia develop gout every year, depending on the level of uric acid in blood. The higher blood uric acid level the greater is the risk of development of gout.

The following measures can help control blood uric acid level and prevent development gout:

  • Adequate fluid intake is important. Drink at least 2-4 liters of water daily to help flush out uric acid easily without chance of deposition in urinary tract. It is better to have plain water instead of carbonated drinks or sweet drinks.
  • Reduce alcohol intake, especially beer. If possible completely avoid alcohol. Alcohol increase uric acid production and reduce uric acid excretion, thus increase blood uric acid level.
  • Avoid foods with high purine content. Eat more vegetables. Even high purine containing vegetables (such as asparagus, spinach, cabbage etc.) are not harmful.
  • Get protein requirement from low purine protein sources such as fresh water fish, low fat dairy products.
  • Reduce intake of red meat, sea foods, and other high purine foods.
  • Maintain a healthy body weight. Reduce body weight to normal (if possible) to control blood uric acid levels. The risk of gout is high if BMI is more than 35.

 

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