All About Gout

By Kathy Hubbard

 
Henry VIII had it. So did Benjamin Franklin, Alexander the Great, Beethoven, both of my brothers, my father and my friend, Jim. Although post-menopausal women can get it, it isn’t as common as men having a flare-up of this inflammatory arthritis called gout.
“The signs and symptoms of gout almost always occur suddenly, and often at night,” Mayo Clinic tells us. “It’s characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe.”
Ouch. Gout isn’t just about toes, either. It can affect any joint commonly ankles, knees, elbows, wrists and fingers. The pain is most severe within the first four to twelve hours after it starts.
“After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints,” Mayo says.
What causes it? Let’s turn to Medicinenet.com for their explanation: “Gout is caused by too much uric acid in the bloodstream and accumulation of uric acid crystals in tissues of the body. Uric acid crystal deposits in the joint cause inflammation of the joint leading to pain, redness, heat, and swelling.
“Uric acid is normally found in the body as a byproduct of the way the body breaks down certain proteins called purines. Causes of an elevated blood uric acid level (hyperuricemia) include genetics, obesity, certain medications such as diuretics (water pills), and chronic decreased kidney function.”
There are four stages of gout. The first is asymptomatic hyperuricemia when the blood uric acid levels are high, crystals are forming in the joints, but you have no symptoms. D’uh. Asymptomatic.
The second is acute gout or gout attack which we’ve already described. Interesting to note, is that as many as 84 percent of sufferers may have another gout attack within three years. The third level is called interval gout which is the time between attacks. The patient has no pain, but the low-level inflammation is still there and damaging the joints.
“Chronic gout develops in people with gout whose uric levels remain high over a number of years,” Arthritis Foundation explains. “Attacks become more frequent and the pain may not go away as it used to. Joint damage may occur, which can lead to a loss of mobility. With proper management and treatment this stage is preventable.”
Without a flare-up it’s unlikely you would know if your uric acid levels are high. And, even if you knew that they are, it doesn’t guarantee that you’ll have a gout attack. Confusing? Add to that the fact that you can have low uric acid and still have a gout attack is really baffling.
Your healthcare provider will put you through some tests to diagnose whether or not you actually have gout. They include a blood test; a joint fluid test where a needle draws fluid from the affected area and examined under a microscope; x-rays; ultrasound and/or a CT scan.
There are medications today that can help ease the pain of the attack and to prevent future ones. Your medico will walk you through the choices available to you and discuss how you want to proceed. One thing is for certain, you will want to prevent another attack and that prevention will require you to make some lifestyle changes primarily in your diet.
“Reaching and maintaining a proper weight is an important part of managing gout. Not only does losing weight help reduce the uric acid in the blood, it can lessen the risk of heart disease or stroke, both common in people who have gout, Arthritis Foundation says. They also say that keeping active is important and that you and your medical team should make a plan of action, literally.
Gout used to be called the rich man’s disease because it can be exacerbated by eating lots of red meat, organ meats, shellfish such as shrimp and lobster, sugary beverages and excessive alcohol. If you’ve ever had, or thought you had a gout attack you’ve probably read all the info on what you can eat and drink to avoid another attack, if you’re interested search “gout diet” for lots of good advice.
 
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at [email protected].