Gout, or gouty arthritis, is a form of inflammatory arthritis that is very painful. It occurs as a result of excess uric acid in the bloodstream. The acid forms fine, needle-like crystals within joints, causing sudden and severe pain, tenderness, swelling, and stiffness.
Gout is actually one of the oldest documented diseases, first recorded by the ancient Egyptians in 2600 BC. Throughout history, it has been called the “disease of kings” or “rich man’s disease” because of its link to a diet rich in red meat, seafood and alcoholic beverages.
Most people initially experience gout at the base of the big toe. The area becomes sore, red, warm and swollen. Gout can also affect your ankles, heels, knees, wrists, fingers and elbows.
According to the Arthritis National Research Foundation, gout affects in 8.3 millions Americans. It is very rare in children or young adults. Men are more likely to develop gout, but women who have entered menopause experience an increased risk.
Causes of Gout
Gout is caused by excess uric acid in the body. It is also known as hyperuricemia. Uric acid forms when the body breaks down purines found in human cells and many food substances such as alcohol, fructose-sweetened drinks, meat and seafood. Uric acid is carried through the bloodstream to the kidneys, to be discharged as urine. However, when excessive levels of uric acid are produced, the kidneys can fail to break it down effectively. The remaining uric acid can crystalize in the form of monosodium urate, deposited in the body’s joints.
Aside from dietary factors, gout is also partly genetic, which can elevate risk among certain individuals by increasing the variability of uric acid levels. A positive correlation also exists for individuals with medical conditions like kidney disease, insulin resistance and abnormal lipid levels.
Risk Factors for Gout
- Family history of gout
- Frequent consumption of red meat and shellfish, high-fructose foods and beverages
- Frequent consumption of alcohol, especially beer (more than 2 drinks a day)
- Use of diuretics to manage hypertension
Symptoms of Gout
Gout symptoms will usually appear suddenly, often overnight. Individuals experience a severe pain in the affected joint, which may diminish into discomfort and inflammation. It is most commonly experiences in the big toe joint, ankle or knee.
It may be painful and difficult to move the joint. If left untreated, it can spread to multiple joints. The risk for additional complications, including as the formation of kidney stones, also increases.
Most cases of gout are treated with medication after consulting a medical professional. The types of medication depend on the severity of the symptoms, and overall patient health. Medications are grouped into two classes
Treating Gout Attacks:
- Non-steroidal anti-inflammatory drugs (NSAIDs) – These medications include Advil, Alleve and MotrinIB, and stronger prescription options.
- Colchicine – These medications can reduce gout pain, but carry an increased risk of nausea, vomiting and diarrhea.
- Corticosteroids – Can be injected into the joint or taken orally, and are often recommended for those who can’t tolerate the first two options.
- Block Uric acid production – These meds are used to limit the amount of uric acid produced by the body.
- Improve uric acid removal – Enhances kidney’s ability to dispose of uric acid through urine, but may increase risk of kidney stones.
Managing Gout Pain
Medications are themes proven and effective way to manage gout, however, there are some key lifestyle changes that a patient should consider.
- Drink more water (8-12 glasses per day), and limit the consumption of alcoholic beverage and fructose-sweetened drinks
- Limit purine-rich foods like red meat, seafood and organ meats)
- Exercise regularly and maintain a healthy weight.
- Coffee consumption has been shown to help lower uric acid levels in the body
- Eating cherries can lower uric acid levels and reduce the frequency of gout attacks
If you have experienced sudden and severe pain at the joint of the big toe, or ankle, schedule an appointment at Houston Foot and Ankle Care. We can diagnose your condition and any related issues such as numbness, inflammation or cramping. Dr. Gabriel Maislos is a board certified Houston podiatrist with an expertise in acute and chronic issues affecting the bones and joints of the foot and ankle. He can prescribe medication to relieve pain quickly, advise you on lifestyle adjustments and refer you to a trusted rheumatologist if necessary. Call 713-541-3199 today.