Gout is a form of arthritis which causes pain and swelling in the joints. It happens in people with too much uric acids in the blood. Uric acid is a chemical that is produced when the body breaks down certain foods. Uric acid can form sharp, needle like crystals that build up in the joints and cause pain. Uric acid crystals can also form inside the tubes that carry urine from the kidneys to the bladder. These crystals can turn into kidney stones and cause pain and problems with the flow of urine. The characteristic pain develops when the white blood cells and cells in the joint linings attempt to surround and digest urate crystal deposits. Men are more likely to get gout, but women are increasingly susceptible after menopause.
People with gout get sudden attacks of severe pain, often in the big toe, ankle, or knee. Often the joint turns red and swells. Usually one joint is affected, but some people have pain in more than one joint. The pain from gout can be extreme. The pain and inflammation usually reach their peak intensity within 12 to 24 hours. The symptoms then get better within a few days to weeks.
The best way to diagnose gout is to examine synovial fluid from an affected joint under a microscope to look for urate crystals. To obtain the fluid, a needle is used to withdraw a small amount of fluid. Criteria for suspecting gout include pain initially involving one joint at a time, especially the joint at the base of the big, a complete resolution of symptoms between attacks or a blood test showing high levels of uric acid.
There are several conditions and lifestyle choices that increase the risk for developing gout, including:
- High blood pressure
- Chronic kidney disease
- Consuming excessive amounts of alcohol (particularly beer, whisky, gin, vodka, or rum) on a regular basis
- Consuming large amounts of meat, seafood, or beverages containing high fructose corn syrup
- Taking medications that affect blood levels of uric acid (especially diuretics)
In people already diagnosed with gout, certain factors increase the risk of a flare up:
- Injury or recent surgery
- Consuming excessive amounts of alcohol
- Taking medications that affect levels of uric acid
Gout can be treated with medications that reduce the pain and swelling. There are also medications that can reduce the chance of future gout flares. Most people who have repeated or severe attacks need to take medication to prevent future attacks.
Changing your diet may reduce the frequency of gout attacks. Because obesity is a risk factor for gout, losing weight is an important goal. A gout diet reduces intake of foods that are high in purines and help you limit your body’s uric acid production. Animal proteins are high in purine. Because all meat, poultry and fish contain purines limit your intake to 4-6 ounces daily. You should avoid organ meats, herring, anchovies, and mackerel and mushrooms and asparagus. You should cut down on red meat (beef, pork and lamb) and seafood (tuna, shrimp, lobster, and scallops), alcohol, and foods and drinks that contain high fructose corn syrup. Fructose is the only carbohydrate that is known to increase uric acid. Cutting down on saturated fat lower’s the body’s ability to eliminate uric acid. Choose low fat or fat free dairy products, including cottage cheese and yogurt. Choose fruits and vegetables and avoid refined carbohydrates such as bread, cake, and candy. Fluids can help remove uric acid from the body. Drinking water can flush uric acid from the body.