What is gout?

Gout is a type of arthritis. It is caused by the buildup of uric acid in your joints. It can affect the foot, heel, ankle, elbow, wrist or hand. Most often though, it affects the big toe. Gout is a reoccurring problem that comes and goes. It usually comes on without warning, and then goes away after 7-10 days.

What causes gout?

Uric acid is naturally produced by the liver, and is found in the blood stream. Uric acid is a by-product of certain products, especially those containing purine. Foods that are known to contain large concentrations of purine include: sardines, anchovies, liver, brains, dried peas and beans.

Uric acid is filtered out of the body by the kidneys. It is then excreted in urine. When too much uric acid is produced by the liver, the kidneys are not able to remove it all, and it builds up in the blood stream. This build up of uric acid in the blood stream is known as hyperuricemia. Over time the uric acid crystallizes and ends up settling in joint spaces. White blood cells eventually mistake the crystals as a foreign invader to the body, and gather into the joints as well to attack the crystals. This causes inflammation, ie: swelling, redness, and the typical gout pain.

Diet and gout

Most often, your diet will determine if you get gout. However, heredity is also a factor. About 18% of people with gout find that it runs in their families.

Alcohol can interfere with the removal of uric acid from the body. Regular consumption of alcohol increases the likelihood of getting gout. Other risk factors include:

-Injury to the joint
-Exposure to lead
-Diet. Foods that contain large amounts of purine include red meat, creamy sauces, scallops, anchovies, beans, liver and heavy creamy sauces.
-Medication. Aspirin, levodopa and several other medicines can interfere with the kidneys ability to remove uric acid from the body.
-Excess body weight.

Symptoms of gout

The main symptom of gout is severe pain. If the gout is in the feet, it can be so severe that the sufferer cannot stand. Inflamed skin around the joint can be red and shiny, and over the course of time can get worse. Over the course of time, the frequency of attacks will increase, and the attacks will last longer. If left untreated, more and more joints will be effected and stone-like deposits can build up in the joints. This is known as tophi, and can lead to permanent disability.

Who gets gout

Although it is sometimes referred to as "rich mans disease", anyone can get it. About 5% of all cases of arthritis are actually gout. It is much more common in men than women, and usually develops in men in their late 30's or early 40's. Women usually develop gout later in life, in their 50's or 60's. Medical experts believe that estrogen protects women against hyperuricemia. During menopause when estrogen levels decrease, women lost this protection and uric crystals can start to accumulate in joints.

Diagnosing gout

A physician can usually diagnose gout very easily. A physical examination as well as certain tests are used to measure the amount of uric acid in the blood. Sometimes a sample of fluid is taken from the joints and tested for the presence of urate crystals.

Treatment

Doctors can prescribe several drugs. These drugs work to decrease the amount of uric acid in joints. This helps to reduce the symptoms and frequency of attacks. If not treated, serious permanent damage can occur. This can lead to permanent disability.

Treatments include anti-inflammatories, corticosteroids. These medications can help alleviate symptoms in as little as a week. Before taking any medications for gout, you need to discuss the potential side effects with your doctor. Certain medications can cause severe gastrointestinal and cardiovascular side effects.

Preventing gout

The best medication for gout is prevention. A healthy lifestyle decreases your chances for getting gout. Maintaining a proper weight, and limiting alcohol intake will help. Dehydration is also know to increase the formation of urate crystals. Drinking a lot of water daily will help "flush" uric acid from the blood stream. It is recommended that you drink six to eight glasses of water each day. Also, try to avoid foods high in purine such as alcohol, red meat, sardines, beans, rich sauces, scallops, liver and dried peas.