Out with Gout!

Robert Hedaya

 

Gout is an inflammatory disease. It is a painful form of arthritis that develops in some people who have high levels of uric acid in the blood. In vulnerable people, when levels are too high, crystals form in vulnerable joints and cause sudden, severe episodes of pain, tenderness, redness, warmth and swelling.

 

Who gets gout?

Your chances of getting gout are higher if you:

  • are genetically vulnerable
  • are overweight
  • have heart disease, high cholesterol, high blood pressure
  • drink too much alcohol
  • are male
  • had gastric bypass surgery
  • eat too much meat and fish that are high in natural chemicals called purines
  • take medicines, such as water pills (diuretics), that can bring on gout

 

What causes a gout attack?

A gout attack happens when something, such as a steak with a glass of wine, causes uric acid levels to rise. Sugary sodas and even too much fruit can prompt an attack. Injury can also cause gout. Trauma to the joint can irritate the crystals that have formed in a joint, triggering the attack. The resulting inflammation and pain often strike at night and intensify over the next eight to 12 hours. The symptoms ease after a few days and likely go away in a week to 10 days. Some people never experience a second attack, but an estimated 60% of people who have a gout attack will have a second one within a year.

 

Can I have gout without feeling pain?

Surprisingly, even when there’s no pain, the gout isn’t gone. Low-level inflammation continues to damage joints and gout attacks will (unless you take preventative measures) become more frequent and long lasting. Eventually joint damage may occur, which can lead to a loss of mobility, as well as damage to the kidneys. With proper management and treatment, this more advanced stage is preventable.

 

How do I know my pain is from gout?

Your doctor will need to rule out other potential causes of joint pain and inflammation such as infection, injury or another type of arthritis. Your doctor may take an X-ray, ultrasound, CT or MRI to examine soft tissue and bone. The doctor might also remove fluid from the affected joint and examine it under a microscope for uric acid crystals. Finding uric acid crystals in the joint fluid is the surest way to make a gout diagnosis.

 

How can I prevent or minimize the effects of gout?

Essentially, you do the opposite of all the line items above that make you susceptible to gout.

  • eat and drink non-triggering beverages and foods in moderation
  • avoid sugary foods and drinks
  • review your medications to be sure they are not contributing to your risk
  • eat a heart-healthy diet
  • keep your weight in a healthy range using an age appropriate exercise program
  • avoid organ meats (e.g., liver), anchovies, sardines, herring
  • avoid excessive alcohol, as well as beer
  • use supplements to reduce inflammation

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