Gout is part of the arthritis disease category. People who have this purine problem are also prone to other related problems. Diseases such as kidney stones and rheumatoid arthritis are frequent among those who have gout. Lesch-Nyhan syndrome is another genetic metabolic syndrome that affects how the body deals with purines.

Symptoms

Symptom onset is sudden and intense. The pain occurs in one or more joints. The joint becomes red, swollen, hot, and tender to touch. It is excruciatingly painful to move the affected joint. Occasionally the person may think they have somehow injured the area. The metatarsal-phalangeal joint, especially the big toe, is a favorite target of crystal build up. However, gout can affect hands, fingers, wrists, knees, heels, and other joints.

The skin at the site of the flare up may turn blue or purple in color during the most intense part of the attack. As the attack subsides, the person may experience peeling of the skin or an orange-peel appearance. This will resolve within two to four weeks.

The pain is so intense in the first 24 hours that anything that touches the joint is intolerable. Suffers complain that bedcovers, socks, and shoes are impossible to wear. The pain is what sends the majority of people to the emergency room or doctor’s office seeking relief. Pain seems to be more intense at night when the person is trying to sleep.

Sometimes the pain is so severe the person may experience gastrointestinal upset such as nausea and vomiting. Over the counter remedies can exacerbate these symptoms, due to their effects on the stomach. Ibuprofen should be taken with food to help alleviate such problems.

Frequency

The frequency of attacks varies considerably from person to person. People with uncontrolled purine levels may experience numerous attacks each year. They are also prone to having multiple joints affected at the same time.

Those with a diet or medication strategy to control purine levels can significantly reduce their outbreaks to a couple of times a year. With a multilevel approach to controlling purine, they could go years without and attack.

Treatment

Treatment is aimed at alleviating the immediate symptoms. Non steroidal anti-inflammatory medications such as ibuprofen will relieve redness, swelling, heat and tenderness. It takes about 24 to 48 hours to see an appreciable decline in symptoms. In the meantime, a narcotic analgesic is used to control the pain. Many physicians use a prescription medication called Allopurinol to decrease uric acid levels. It works by inhibiting xanthine oxidase activity which reduces uric acid production. Most people take Allopurinol as a preventative therapy versus as a treatment for an acute outbreak.