I am Dr. Sanjay Alle, Orthopedist. Today I will talk about gout. Gout is arthritis of a small joint caused due to uric acid. What is the cause of hyperuricemia in the blood? Most of the cases are idiopathic. We don't know the exact reason for happening this problem. But the secondary causes could be because of the under secretion of the uric acid or over-production. So, we see medical conditions like hypertension, hypothyroidism. A few of the drugs also cause a uric acid problem. This also happens because of the high content of unhealthy food. Some genetic conditions also cause hyperproduction of uric acid. And there are many conditions which cause hyperproduction of uric acid. So, what are the symptoms? Pain, swelling, inflammation in this condition. So, there are different stages for hyperuricemia. Now, we are having a routine examination of full body check-up. We normally find that there is a high level of uric acid. In the 2nd stage, the patient is having acute symptoms. We see that the patient has acute monoarticular pain and severe pain and inflammation.
In the 3rd stage, it will become chronic if we are not treating at the acute stage. This is very much similar to rheumatoid arthritis. What is the diagnostic investigation we have? In investigation, we get a needle-shaped monosodium urate crystals. Apart from that, we have blood investigations mainly uric acid level in the blood. We also have to do a premium profile just to rule out any nephropathy. This is very much common in the renal stone and what is the treatment as such? We divide the treatment into 2 parts. One is medical and another one is non-medical part i.e. dietary restrictions. We should not give a long list that we should not do this and that. We simply advise the simple basic steps like to avoid red meat, seafood and if they are alcoholic, then they should avoid alcohol, and the 4th is smoking. With these simple things, we get good control over hyperuricemia.
2nd is the medical part. The patient can be treated as per the stages. No medicines should be recommended in the initial stages. If they are overweight, then weight reduction. 2nd is dietary restrictions. Acute stages can be divided into 2 parts. We also give a short course of steroids. While giving steroids, we should be more cautious in diabetic patients. If the diabetes is not under control then w should refrain from using the glucose steroids. The only complication will be of diarrhea. If the patient is compatible with the symptoms of diarrhea then we can simply shift to the short course of steroids. We have to select the patient for long-term treatment. If the patient is having 2-3 episodes then the patient is for a long term treatment. So, what are the treatments? A few treatments are having a side-effect of hypersensitivity reaction. In renal conditions, we should customize the dose which is very difficult. So, our main is to reduce the uric acid level less than 6 in a normal patient and less than 5 in renal impairment patients. This is the basic information about hyperuricemia. I hope you have basic information about hyperuricemia. For more information, you can contact me through Lybrate.