Gout

What is gout?

Gout is a type of inflammatory arthritis that occurs when uric acid levels are too high. Uric acid is produced when your body breaks down proteins called purines. Uric acid can form crystals within joints and this triggers a huge inflammatory reaction. Repeat gout flares can result in the accumulation of uric acid crystals, called tophi, and severely damage the joint overtime.

 

What are the symptoms of gout?

Gout presents as a sudden red, hot, swollen joint.  One of the most common places for gout to occur is the big toe joint, also known as Podagra. The area is usually very painful even to light touch. Gout attacks typically last 3-10 days. Gout is most common in men and post-menopausal women.

 

How is gout diagnosed?

Gout is usually diagnosed on a clinical basis.  X-rays are taken to evaluate the joint condition. The level of uric acid in blood is also checked, however it may or may not be elevated at the time of a gout attack. Removing fluid from the joint to check for uric acid crystals may be recommended in some cases to rule out an infection.

 

What is the treatment for gout?

A steroid injection can provide relief very quickly. Medications can be prescribed that will also act quickly to reduce the joint inflammation. You should avoid using ice as it causes more crystals to form. Once you have a gout attack, you will likely have another. It is important to follow up with your primary care physician to have your uric acid monitored. Diet modification is important to reduce uric acid. Sometimes a long-term medication is required to control your uric acid.  Once the joint is severely damaged with the accumulation of uric acid crystals, surgery may be considered and joint fusion is the procedure of choice for the big toe joint. For those with very large accumulations of uric acid crystals, IV therapy targeted at reducing the tophi may be recommended prior to surgery.

 

What foods should I avoid?

Food rich in purines should be eaten sparingly to help reduce uric acid and the frequency of gout flares. These foods include:

  • Beer and grain liquors
  • Beef, lamb, and pork
  • Organ meats (such as liver and kidney)
  • Seafood (shellfish like shrimp, lobster, mussels, anchovies, and sardines)
  • High-fructose treats (soda and candy)
  • Fast food

Eating a plant based diet with lots of green, leafy vegetables and drinking plenty of water is important to good health and preventing gout.  Some studies show that coffee and cherries may also beneficial at preventing gout.