Gout
(Gouty arthritis)
Uric acid is produced when our bodies break down purines, which are in present in our cells and some high-protein foods. Uric acid is transported by the blood to the kidneys and eliminated in urine. Sometimes however, uric acid accumulates in the blood and forms crystals. Gout is a painful and often debilitating condition that develops when the crystals are deposited in tissues. The deposits most commonly affect joints in the lower limbs (knees, ankles, feet), and the first attack often occurs at the base of the big toe.
Oftentimes, attacks start overnight and in the early morning hours. They are unpredictable and can occur a few days or months apart, and last anywhere from a few hours to a few weeks. The initial attack usually affects a single joint and is accompanied by redness, swelling and severe pain.
When does the condition usually develop?
Gout usually develops in adulthood and is rare in children. It develops earlier in men (30 to 45 years old) than in women (after age 55), but the incidence is equal in men and women older than 65 years.
What can I do to prevent an attack?
Since foods rich in purines can trigger an attack, it is important to limit one's consumption of these foods. Purine-rich foods include red meat, certain fish and seafood, alcoholic beverages, particularly beer and red wine, as well as sugar, most notably fructose, which is found in soft drinks. If need be, you may want to consult with a professional who will be able to help you make changes to your diet.
Also, individuals who are overweight are more likely to develop gout, even at a younger age. Losing weight is a preventive measure that can help you manage your gout. Physical activity also contributes to maintaining healthy joints by strengthening the muscles around them.
Lastly, medication can be used to lower uric acid levels in the blood. There are two categories for medication that can help prevent attacks: those that increase the elimination of uric acid and those that reduce its production.
What if an attack occurs?
Treatment of a gout attack aims to quickly relieve pain and swelling. Anti-inflammatories are the treatment of choice and are particularly effective when started at the first signs of an attack. Colchicine is another medication that is prescribed to treat gout. Resting, elevating and icing the joint (in 20-minute period) is recommended. It is also important to drink plenty of fluids (alcohol- and sugar-free beverages). Afterwards, depending on your overall medical condition and, in an effort to reduce the frequency of gout attacks, your doctor will determine whether preventive treatment is appropriate for you.