The Better Life Experts | March 24, 2009

What Is It?
Gout is a disease caused by the buildup of uric acid in the joints. It occurs when the liver produces more uric acid than the body can excrete in the urine, or when a diet high in rich foods (e.g., red meat, cream sauces, red wine) produces more uric acid than the kidneys are able to filter from the blood, resulting in a condition, called hyperuricemia. Some people with hyperuricemia (high levels of uric acid in the blood) never get gout. But, if uric acid crystals form, a painful gout attack can occur at any time. Anyone who has hyperuricemia is at risk of having a gout attack.

Over time, uric acid in the blood crystallizes and settles in the joint spaces, causing swelling, inflammation, stiffness, and pain, usually in the area of the big toe joint. Although 90% of people with gout have an attack in their big toe, other joints affected may be the instep, ankle, knee, wrist, and fingers. The symptoms usually come without warning, but some people have minor pain in the ankle, soreness in the heel, or twinges of pain in the big toe before the attack.

Who Gets It?
  • An estimated 5.1 million people in the United States live with gout, according to the National Health and Nutrition Examination Survey III, 1988-1994.
  • Gout rarely affects children or young adults.
  • Adult men, particularly those between the ages of 40 and 50, are more likely to develop gout than women.
  • Most women experience gout after menopause and have other medical conditions, such as high blood pressure causing kidney problems, and are taking medication that affects their body’s ability to keep uric acid levels low. Most of these women also have joint damage, sometimes including inflamed “tophi”—large crystal deposits made up of uric acid.
  • There may be a genetic link: many people with the condition have a family history of gout.
What Causes It?
Although a gout flare may occur for no apparent reason, there are a few known causes, or triggers. These include:
  • Stress or stressful events
  • Joint injury
  • Drinking too much alcohol
  • Eating too much of certain foods
  • Infection or another illness
  • Surgery
  • Crash diets
  • Rapid lowering of uric acid levels with uric acid–lowering medicines
  • Certain medicines known to raise serum uric acid levels
  • Some cancer treatments
How is it Treated?
With or without treatment, the symptoms usually go away within 3 to 10 days, and subsequent attacks may not occur for months or even years, if at all. However, over time attacks can become more severe, last longer, and occur more often. The pain of a gout flare can be excruciating. Even though you know it will lessen over time, pain is an important part of your overall health and should be addressed. Proper management of gout includes a long-term treatment plan addressing hyperuricemia. Dietary recommendations that may help to eliminate the onset of gout and flare ups include the following:
  • Contact your healthcare provider for instructions and medication recommendations.
  • Take all prescription medications as directed by your physician.
  • If your healthcare provider recommendations a nonprescription medication (over the counter) for inflammation, take it as directed.
  • Rest.
  • Use cold packs as directed to reduce inflammation.
  • Make follow up appointments with your physician to test uric acid levels in the blood.
  • Maintain a healthy body weight and a well-balanced diet.
  • Avoid alcohol – especially beer.
  • Exercise regularly.
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