Gout

Gout is a medical condition characterized by recurrent attacks of acute inflammatory arthritis. Because consumption of alcohol, meat, seafood and sugary drinks are thought to be strongly associated with the development of the condition, it’s been called “the disease of kings” and “rich man’s disease.” 

Symptoms

Caused by elevated levels of uric acid in the blood, symptoms of gout include heat, tenderness, redness and excessive swelling of the joints. Nearly 50% of all cases affect the metatarsal-phalangeal joint of the big toe (called podagra gout), but gout can also affect your ankles, knees, hands, wrists, fingers and elbows. Sometimes gout shows itself in the form of kidney stones, urate nephropathy (decreased kidney function) and tophi (visible lumps of uric acid crystals under the skin). 

Joint pain caused by gout is usually experienced in the middle of the night and can be excruciating. Sometimes fatigue and fever are present.

Causes 

As stated above, gout is caused by elevated levels of uric acid in the blood. A substance normally found in the body, uric acid results from the breakdown of purines (which are found in many foods). Uric acid usually dissolves in the blood and is expelled through the kidneys, which turn it into urine. However, if the kidneys fail to eliminate enough uric acid or if a person ingests a lot of food and/or drinks high in purine, then the increased levels of uric acid build up in the blood (a condition called hyperuricemia). The large amounts of uric acid begin to crystalize and the resulting urate crystals deposit themselves into the joints, tendons and surrounding tissue — which then causes gout. 

According to medical sites like WebMd and the National Institute of Arthiritis and Musculoskeletal and Skin Diseases (NIAMS), there are many things that contribute to elevated uric acid levels in the blood including genetic predisposition, obesity, eating foods high in uric acid, frequently consuming alcoholic beverages, taking certain medications (aspirin, niacin and diuretics, for example), recent trauma or surgery, and other health problems like hypothyroidism, psoriasis, diabetes, high blood pressure, hemolytic anemia and Lesch-Nyham syndrome/Kelley-Seegmiller syndrome (a rare condition in which the body lacks the enzyme needed to break down uric acid). 

The most common foods and beverages high in purine/uric acid include alcohol, fructose-sweetened items, meat and seafood.

Treatment and Prevention

There are two areas people with gout need to focus on for treatment: help controlling the painful attacks when they occur and help reducing the number of gout attacks.

There are several medications you can take during gout attacks to help with fast pain relief, including steroids and nonsteroidal anti-inflammatory drugs (NSAIDs). There are also medications, such as Colchicine and Pegloticase (Krystexxa), that help with long-term control of the attacks. If significant swelling of the knee or ankle occurs, your doctor may relieve the pain by inserting a needle into the joint and drawing out the excess fluid.

Rheumatology experts agree that you can control gout and reduce the number of attacks of gouty arthritis simply by reducing your intake of high purine foods and beverages (a list of which you can find here), as well as managing your weight and living an active lifestyle. 

If left untreated, gout can lead to serious kidney damage.