Gout is sometimes thought of as a result of “rich” living. Some of its more famous sufferers included King Henry VIII and Benjamin Franklin.
Franklin once wrote a conversation with “Gout” in which he called it “my enemy; for you would not only torment my body to death, but ruin my good name; you reproach me as a glutton and a tippler.”
Gout is an inflammatory arthritis condition caused by a buildup of uric acid in the body. Uric acid can build up in joints and tissues as crystals and cause pain, swelling, redness and heat.
A common site for the ailment is the big toe, but other joints can be affected, including other toes, ankle and knee. It usually only affects one joint at a time.
The Centers for Disease Control and Prevention lists several factors that increase the likelihood of gout, including:
- Being male.
- Being obese.
- Having certain conditions, including congestive heart failure, hypertension (high blood pressure), insulin resistance, metabolic syndrome, diabetes and poor kidney function.
- Using certain medications such as diuretics like hydrochlorothiazide.
- Drinking alcohol. The risk of gout is greater as alcohol intake goes up.
- Eating or drinking food and drinks high in fructose.
- Having a diet high in purines, which the body breaks down into uric acid. Purine-rich foods include red meat, organ meat and some kinds of seafood, such as anchovies, sardines, mussels, scallops, trout and tuna.
Gout can be diagnosed with a combination of a physical examination, X-rays and lab tests. It can only be diagnosed during a flare-up when the joint is hot, swollen and painful and when a lab test finds uric crystals in the affected joint.
Treatments include management of pain with nonsteroidal anti-inflammatories such as ibuprofen, with steroids or anti-inflammatory medication.
Changes in lifestyle may also help control the condition, such as losing weight, limiting alcohol and consuming fewer purine-rich foods.
Learning arthritis management skills, staying physically active, especially in low-impact activities that are easy on the joints such as walking, swimming and bicycling, also will help.
Podiatrist Dr. Ralph Wentz of Wentz Foot and Ankle said gout and kidney stones are two of the most painful conditions a man can experience.
Males are about four times more likely to have the condition, although females can get it too.
“It’s so painful, you can’t work, you can’t wear a shoe,” he said.
He said sometimes even the weight of a bedsheet will cause extreme pain.
Wentz said he often sees patients with gout and can usually control a flare-up within about two days with medication.
While people have heard of the old folk remedy of drinking cherry juice, “Indomethacin and colchicine are the ‘go-to’ drugs for gout,” he said.
They act to rapidly reduce inflammation from gout.
Another drug, allopurinal, is effective at preventing gout by reducing uric acid in the body.
Wentz said it is important to address gout as soon as possible when a flare-up starts.
“Make an appointment as soon as you can. You want to be seen urgently,” he said.
Wentz said lab work can confirm gout as opposed to an infection, which has some of the same symptoms of redness, swelling and heat.
Wentz said gout is a transient form of arthritis, but repeated bouts of gout can lead to permanent arthritis in the affected joint and sometimes other conditions such as gout-related kidney stones.
In addition, Wentz advised those prone to the condition to stay well-hydrated and drink eight glasses of water each day, avoid all alcohol and avoid shellfish like shrimp.