What is gout?

An introduction to gout

Gout is an arthritic condition, where high levels of uric acid crystallise around joints causing severe pain and inflammation. It is more common among men than women, and is often triggered by obesity and excessive consumption of alcohol.

The word ‘gout’ comes from the Latin word gutta and the Old French word gote which mean ‘a drop.’ This is because it was originally thought that gout was caused by drops of viscous humours seeping into joints, causing pain and inflammation. In fact, now we can confirm that instead of viscous humours, it is uric acid which results in gout.

Disease of the Kings

In days gone by, as the wealthy were the only people who were able to binge on wine and good food, gout was more common among the monarchs and higher classes.

Henry VIII and Leonardo da Vinci are both recorded to be gout sufferers. For this reason, gout was seen as a disease of the kings, brought about as a result of an excess of good living. In the Victorian era, the disease almost became a status symbol, recognised to afflict only those living in luxury. Charles Dickens, one of the first authors to rebel against class divisions in society, put forth a satirical discussion of gout in Bleak House:

Other men's fathers may have died of the rheumatism or may have taken base contagion from the tainted blood of the sick vulgar, but the Dedlock family have communicated something exclusive even to the levelling process of dying by dying of their own family gout.

Nowadays, the street-cred once gained by gout has somewhat diminished, and though the condition does still seem to run in families, treatments have become far more effective and accessible.

How is gout diagnosed?

Gout is not usually difficult to diagnose. There are not massive variations in the way symptoms manifest themselves in different people. However, the symptoms may be confused with other types of arthritis or trauma to your joint. For this reason, further tests are usually conducted to confirm the diagnosis.

In theory, checking for the presence of crystals in the joint is the most conclusive way of proving the existence of gout. This is not always the easiest or most practical option, so other tests may be performed instead.

A simple blood test taken a few weeks after an attack of gout can detect high levels of serum uric acid. An x-ray or physical examination can be used to determine that there is inflammation in the joint, and can also rule out other health conditions. Finally, a sample of fluid from inside the joint, called synovial fluid, can be taken and examined, where the presence of uric acid crystals or other infections or bacteria can also be determined.

What’s next?

Once you have a diagnosis of gout, your doctor will likely ask for a follow-up appointment to check your level of uric acid. He will also recommend ways of lowering this, primarily through diet. However you may also find certain herbal or conventional medicines to be beneficial.

Once you have been diagnosed with gout, it will not be difficult for you to recognise subsequent attacks of it, and it is not usually necessary for you to go back to your doctor.