What is Gout?
Gout is a type of arthritis that is caused by the accumulation of uric acid in the body and the joint fluid (hyperuricemia). The build-up of uric acid commonly happens when the body does not process certain proteins well in our body, which occur naturally in our diets, called purines (PURE-EENS). The actual accumulation of uric acid results when the body does not eliminate uric acid through the kidneys and urine, or when the body produces too much uric acid. It is a hereditary tendency to accumulate uric acid. This hereditary tendency may skip an individual or a generation and reappear in the children of someone without any signs of gout. Gout is most commonly seen in males between the ages of 50 and 60, although there are occurrences in females and in younger males.
What are the symptoms of Gout?
The onset of gout is heralded by a sudden onset of pain in one or more joints, commonly in the joint of the big toe of the foot. Redness, swelling, and warmth over the joint accompany the pain. Often the patient does not remember injuring the joint before the pain begins. Many patients report that they first notice the pain in the middle of the night and relate that even the bed sheets cause pain when they touch the involved joint. Other typical areas of pain are the instep of the foot, the ankle, or the knee. When the foot is affected, it is difficult and painful to wear shoes and to move the joint or stand on the foot.
How is the Gout diagnosed?
Diagnosis of gout is based on personal and family history along with and examination by the doctor that often finds the common symptoms of gout and makes a clear diagnosis. Uric acid levels are often determined by performing blood tests, and uric acid crystals can be found by examining joint fluid. Both bones and joints are examined through x-rays to rule our abnormal changes due to gout.
How is Gout treated?
The first step for treating gout is obtaining a correct diagnosis. An acute attack of gout is most often managed through oral anti-inflammatory medications. Over-the-counter medications may reduce symptoms of gout; however they are rarely effective in treating the acute pain, swelling, and inflammation. When the symptoms of gout occur in the toe, relief is often found by elevating the foot, avoiding standing and walking, and wearing loose slippers until consulting a podiatric physician.
What if I don’t get treatment?
If you don’t get treatment, a gout attack can last for days or even weeks. If you keep having more attacks, more joints will be affected, and the attacks will last longer.
Over time, if left untreated gout attacks can lead to soft tissue swellings of uric acid crystals called tophi in your joints. Tophi usually form on the toes, fingers, hands and elbows. You can also get kidney disease or kidney stones. Over time, the bone around a joint may be destroyed by gout, and may require surgical treatment to repair the joint and treat the arthritis.
What can I do to avoid gout attacks?
Once we have taken care of your current pain, we will likely refer you to your primary care physician. He or she may prescribe medicines to prevent future gout attacks. These medicines can wash the uric acid from your joints, reduce swelling and keep uric acid crystals from forming. It is important that your doctor determines whether your body is either producing too much uric acid or not eliminating it properly. This is important in order to determine the effective medication to treat the gout.
Can I lower my risk for developing an acute Gout attack?
Foods high in purines can elevate uric acid levels and cause an acute attack of gout. Such foods include red meats, shellfish, beer, red wine, and salt. Certain medications such as diuretics (water pills); often prescribed to control high blood pressure or reduce swelling may be responsible for acute attacks of gout. Gout may also be caused by stress, infection, and trauma. The chance of an attack of gout can be reduced or the severity of an attack can be lessened by consuming 6-8 glasses of water daily, eating an appropriate diet, and evaluating current medications. Regular visits to a podiatric physician will also reduce the chances of an attack if you have a personal of family history of gout.