About 20 years ago (more like 30 if I am honest), while in my first semester of nursing school, I developed a swollen, red, flaming hot joint in my left big toe. I had no idea what was happening, but I did know that I was unable to get my shoe on, and it was so painful, it required immediate attention.
My doctor drew some blood, and told me the results would come back in a day or so; however, although I was an atypical patient, it appeared to be Gout and so he was going to treat it as such.
I had no idea what Gout was other than something old people got. Keep in mind I was still quite young.
Tests came back confirming it was, indeed, gout. Typical gout sufferers are post-pubescent men, with a peak age of 75, and women aren’t usually susceptible until they are post-menopausal. In fact, Gout is nine times more common in men than in women.
So what was I doing wrong? I was drinking a lot of coffee and Dr. Pepper. Remember, I said I was in nursing school - and I won’t even mention my diet, which can have a huge effect.
So what is gout?
The signs and symptoms are almost always acute, occurring suddenly, often at night and completely without warning. It can wake you in the middle of the night, and hurts to even have a sheet touching the area.
Gout occurs when the bodily waste product known as uric acid is deposited as needle-like crystals in the joints and/or soft tissues. The overload of uric acid causes joint inflammation (arthritis). Hence, the reason for a blood test to check for an elevated uric acid level.
Uric acid is a breakdown product of purines, natural substances found in all of the body’s cells, and in virtually all foods. Abnormality in processing uric acid can cause attacks of painful arthritis (a gout attack), kidney stones, and, in worst case scenarios, kidney failure. Gout is one of the most frequently recorded medical illnesses since it’s medical identification. Today, approximately six million people in the United States suffer from gout.
In most people, like myself, gout initially affects the joints of the big toe, a condition called Podagra. However, in others, many joints and areas around the joints can be affected. Chalky deposits of uric acid, also known as tophi, can appear as lumps under the skin that surrounds the joints. Uric acid crystals can also deposit in tiny fluid-filled sacs (bursae) around the joints. These crystals stimulate inflammation in the bursae, leading to Bursitis. In rare instances, gout leads to a more chronic type of joint inflammation that imitates Rheumatoid Arthritis. Most patients with gout will experience repeated attacks of arthritis over the years.
I mentioned my gout was directly related to my diet, lack of rest and stress level – all causes of an acute attack. However, there are many ways for developing gout: medicines, genetics, obesity, alcohol consumption, and lead exposure. Joint injury, surgical stress and many medical illness (high blood pressure, hypothyroidism, fad diets, fasting and dehydration).
Probably the best thing that you can do if you are a gout sufferer is to eat a balanced diet to help reduce uric acid levels in the blood. Since purine chemicals are converted by the body into uric acid, purine-rich foods should be avoided.
Examples of purine-rich foods are below. Researchers have reported that meat or seafood consumption increases the risk of gout attacks, while dairy food consumption helped to reduce the risk. Protein intake or purine-rich vegetable consumption was not associated with an increased risk of gout.
High-purine foods and drinks:
• Alcohol
• Anchovies
• Asparagus
• Beef Kidneys
• Beer
• Brains
• Caffiene
• Dried Beans And Peas
• Fried Fatty Foods
• Game Meats
• Gravy
• Herring
• High Fructose Corn Syrup
• Liver
• Mackerel
• Mushrooms
• Sardines
• Scallops
• Sugar-Sweetened Soft Drinks
• Sweetbreads
Managing your gout
Effectively managing gout isn’t just a matter of taking pain medicine during an attack. Lifestyle changes, nutritional changes, exercise, and weight loss if needed will all help. In addition, your doctor may consider medicines to help address the high uric acid causing your gout.
By knowing how to reduce your pain during flare-ups and ways to keep uric acid at a lower level, management of your gout can be more effective, both short- and long-term.
If you experience sudden, intense pain in a joint, call your doctor. Gout that goes untreated can lead to worsening pain and joint damage.
Sources: American College of Rheumatology; Gout.com; Arthritis Foundation; NIAMS. http://www.niams.nih.gov.