Gout

I began getting gout attacks in my late 20s. At that time I had not heard of gout and had no idea what gout was. I was working a job that had me doing a lot of manual labor and often left me with a schlew of minor injuries; sore back, sore knee, cuts, bruises, just generally beating myself up. So my foot would get sore and swell up and I would assume that I had kicked something or dropped something on it and tried to go about my business as best I could. Adding to this malaise, my doctor did not recognize it as gout and would usually give me a pain killer or anti-inflammatory and send me on my way with the advice to be more careful.

This went on for a long while. It wasn’t until I changed jobs and moved across the state that a doctor in a clinic took one look at my foot and said, “looks like you’ve got some gout going on there.” Just that easy. I mean this was five or six years into this problem. So I had some tests and now I’m on a daily pill. My doctor tells me that my body simply doesn’t make enough whatever to break down the purine in my system, but he and I both know it has an awful lot to do with my weight. So here, in the hope that it may help you, is what I’ve learned about gout.

Gout is usually characterized by recurrent attacks of inflammatory arthritis—a red, tender, hot, and swollen joint. Pain typically comes on rapidly in less than twelve hours. The joint at the base of the big toe is affected in about half the time. Though I have had it occur in my ankle, knee, hand, and elbow at different times. Fortunately, I have never had it occur in more than one location at a time.

It is more common in men than in women. One doctor told me that he sees a lot of men get it in their 30s. The cause is a combination of diet and genetic factors. It occurs more commonly in those who eat a lot of meat, drink a lot of beer, or are overweight. The underlying mechanisms involves elevated levels of uric acid in the blood. When the uric acid crystallizes and the crystals deposit in joints, tendons, and surrounding tissues, an attack of gout occurs.

Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, or colchicine improves symptoms. Once the acute attack subsides, levels of uric acid are usually lowered via lifestyle changes, and in those with frequent attacks, allopurinol or probenecid provides long-term prevention.

I have heard a lot of things about gout prevention but what I noticed is that high-sugar, high-caffeine drinks, red meats, alcohol, shellfish, peas, gravy, are all things to avoid. Staying hydrated is also huge, it seems that the deposits concentrate more easily when you’re dry, so drink lots of water. I’ve heard things about milk that are both good and bad. Lots of people have mentioned cherry juice as a cure. Some folks say taking vitamin C and eating a diet high in low fat dairy products may be preventative. The thing that has helped me the most, getting on a daily pill to control my uric acid levels.

Gout was historically known as “the disease of kings” or “rich man’s disease”. I am neither of those things, though, at one point I did eat a lot of red meat and that is a big contributor. Gout has been recognized at least since the time of the ancient Egyptians, so what I want to know is, how come it took 5-years for someone to tell me that’s what I had?

About Gout

Gout. Also called: gouty arthritis. Gout is a form of arthritis characterized by severe pain, redness, and tenderness in joints.

Gout is very common, with more than 3 million US cases per year. It is treatable by a medical professional, but does require a medical diagnosis and lab tests or imaging are often required

Pain and inflammation occur when too much uric acid crystallizes and deposits in the joints.

Symptoms of gout include severe pain, redness, and swelling in joints, often the big toe. Attacks can come suddenly, often at night.

During an acute attack, anti-inflammatory medications (NSAIDs) can help to relieve pain and shorten the length of the attack. Patients with chronic gout can use behavioral modification such as diet, exercise, and decreased intake of alcohol to help minimize the frequency of attacks. Additionally, patients with chronic gout are often put on medications such as colchicine.

Symptoms of Gout

Requires a medical diagnosis

Symptoms of gout include severe pain, redness, and swelling in joints, often the big toe. Attacks can come suddenly, often at night.

People may experience:
Pain areas: in the joints, ankle, foot, knee, or toe
Joints: effusion, lumps, or stiffness
Also common: physical deformity or redness

Treatments for Gout

Treatable by a medical professional

During an acute attack, anti-inflammatory medications (NSAIDs) can help to relieve pain and shorten the length of the attack. Patients with chronic gout can use behavioral modification such as diet, exercise, and decreased intake of alcohol to help minimize the frequency of attacks. Additionally, patients with chronic gout are often put on medications such as colchicine.

Prescriptions:
Anti-inflammatory: Indomethacin (Indocin), Diclofenac (Voltaren)
Steroids: Prednisolone (Orapred)
Other treatments: Probenecid, Allopurinol (Zyloprim), Febuxostat (Uloric), Colchicine (Colcrys)

Self-treatments for gout:
Anti-inflammatory: Ibuprofen, Naproxen (Aleve)
Pain reliever: Acetaminophen (Tylenol)
Soothing remedies: Ice pack

Prevention of gout:
Lifestyle: Physical exercise, Weight loss

Medical specialists for gout:
Rheumatologist: Specializes in arthritis and other rheumatic diseases.
Primary care provider (PCP): Prevents, diagnoses, and treats diseases.

Consult a doctor for medical advice 
Sources: Mayo Clinic and others.
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