Gout Explained

Everything you need to know about gout

(RxWiki News) Once called the "disease of kings," gout is marked by tenderness, redness and pain in joints — mainly in the big toe. Read on for some helpful tips to prevent gout flare-ups.

Gout is a type of inflammatory arthritis caused by excess uric acid. Uric acid is a breakdown product of purines, which are part of many foods. The uric acid crystalizes in the joints — mainly the toes, ankles, hands and wrists — causing painful inflammation. In severe cases, excess uric acid can cause kidney stones, permanent kidney damage and even kidney failure.

Who Is at Risk?

Patients with a family history of gout are more likely to develop the condition, and men tend to develop gout more often than women. However, women are increasingly vulnerable to gout after menopause. Additionally, adults develop gout more commonly than children. Patients with kidney disease are also at an increased risk.

Symptoms

Gout is most commonly associated with swelling, tenderness, stiffness, redness and pain in joints. This most often occurs in the feet, mainly in the big toe. But it can also affect the knees, ankles, hands and wrists.

Although gout is a type of arthritis, it is “episodic” rather than chronic. A patient may have pain in the joint for days or weeks but then may not exhibit any symptoms for a long period of time. Episodes are likely to be the most painful in the first four to 12 hours. Subsequent discomfort may then last for between a few days and a few weeks. After this, episodes may be more prolonged and impact more joints. Joint mobility can become limited as the disease advances.

Causes

The amount of uric acid in the body may be high due to overproduction or underexcretion by the kidneys. This accumulation of uric acid can lead to the development of “needle-like urate crystals” in a joint or in the tissue around a joint. These crystals might draw white blood cells to the area, causing the pain characteristics of gout.

Certain types of food and medication can cause uric acid concentration to increase. For instance, seafood and red meat are both high in purines (a compound that creates uric acid when metabolized). Drinks and foods containing high fructose (sugar) concentrations, as well as alcohol, are also linked to the development of gout. Additionally, specific diuretics, immunosuppressants commonly used in organ transplants and low-dose aspirin can all increase the amount of uric acid in the body.

Diet and Lifestyle Recommendations

To avoid future gout attacks, consider the following diet and lifestyle changes:

  • Drink plenty of water and avoid drinks containing high fructose corn syrup.
  • Limit alcoholic beverages.
  • Maintain a healthy, balanced diet. Eat whole grains, dairy products, vegetables, legumes and fruits. Avoid foods that are high in purines, such as red meat, organ meat and seafood.
  • Obtain protein from low-fat dairy products.
  • Keep your body in good shape by eating well and working out. However, it should be noted that quick weight loss may lead to a rise in uric acid concentration in the blood. Some patients may also be able to switch medications if theirs are connected to high levels of uric acid.

Treatment Options

Treatment for gout usually involves medications. The goal of gout therapy is to treat acute attacks and prevent future attacks, as well as to reduce the risk of complications from gout, such as the development of tophi from urate crystal deposits. Your doctor will determine the best medication for you.