Is gout just a rich man’s malady?
No. Gout was once thought to be the result of overindulging in rich foods and alcohol. Gout had the reputation of afflicting kings and nobles, who at one time were among the few who could afford to eat plentifully. It is now known that rich foods and alcohol do not cause gout, although they can make its symptoms worse.
For anyone who suffers from gout however, it is a king-sized pain. Gout causes sharp and excruciating pain that affects the joints. Gout most often affects the base of the big toe but can also affect the elbow, knee, foot, hand, arm or shoulder. Scientists now know that the cause of gout is too much uric acid in the blood. This excess uric acid ends up in the joints or in lumpy crystals that form under the skin.
Am I in danger of getting gout?
The uric acid can also settle in the kidneys, causing kidney stones and poor kidney function.
Gout usually affects men over age forty, but it can affect anyone, large or small, man or woman. Gout is much more frequent in men, at least up until about age 60, when the ratio of men and women who suffer from gout evens out. After age 80, more women than men suffer from gout.
When the level of uric acid in the blood is too high, gout can occur. This excess uric acid is usually caused by a failure of the body to excrete it efficiently. Some people may suffer from excess uric acid because their bodies are producing too much of it. Rarely, a genetic disorder can cause gout.
How do I know if I have gout and how can I treat it?
Gout can look and feel like an ordinary infection or arthritis of a different type. Your doctor must therefore diagnose your gout before a treatment can be recommended. The doctor will use a syringe to extract some fluid from your joint, and then look at the fluid under a microscope to see, if there are uric acid crystals present, which would indicate gout.
If you do have gout, as evidenced by the presence of uric acid crystals, the doctor can recommend treatment to ease the pain, avoid future attacks, and prevent serious complications. Medications to control inflammation and pain can be quite helpful. Such medications include corticosteroids, non-steroidal anti-inflammatory drugs like ibuprofen, and colchicine. Medications to lower urate levels (such as allopurinol or probenecid) can also be helpful, although these can have significant side effects and adverse reactions.
What other strategies can I use to minimize the effects of gout?
- You can make life with gout more bearable.
- Use warm or cold compresses on painful joints.
- Make a bedclothes tent frame to keep your bed covers from pressing on your feet, if they are affected.
- Be conscious of your diet.
- Drink a healthy amount of water.
- Avoid or limit foods that contain a lot of purine. Among the meats high in purine are beef, pork, lamb, and especially organ meats like liver.
- Avoid alcohol, especially beer. Many fish and fish products are high in purine and should be avoided, particularly anchovies, sardines, and caviar.
- Limit your consumption of spinach, asparagus, mushrooms, oatmeal, and dried beans. Many of these are healthy foods normally but can increase the urate levels in people with gout if you eat too much of them.
Most importantly, if you have gout and are overweight, consider losing some weight. This will reduce the urate level in your blood. Also, if you are taking a diuretic medication like HCTZ, which can affect urate levels, ask your doctor if a substitute medication would work for you.