Without warning and, for some reason, in the middle of the night, gout strikes — an intense pain in a joint, most often the big toe, but sometimes other joints, including knees, ankles, elbows, thumbs, or fingers.
Ask any person who has had an attack of gout and they will confirm that it is excruciatingly painful.
What is gout really?
Gout is actually a form of arthritis. It is the body’s reaction to irritating crystal deposits in the joints. It happens in people who have too much uric acid in the blood. Uric acid can form sharp needle-like crystals that build up in the joints and cause pain
The most common factor that increases your chance of gout and gout attacks is excess consumption of alcohol, especially beer. It used to be known as “the disease of kings” since it was mainly seen in wealthy men who drank and ate too much.
Is there a test for gout?
Yes. To test you for gout, your doctor can take a sample of fluid from the joint that is in pain. If he or she finds typical gout crystals in the fluid, then you have gout. Even without checking the fluid from a joint, the doctor might still strongly suspect gout if:
- You have had pain and swelling in one joint, especially the joint at the base of the big toe
- Your symptoms completely go away between flares, at least when you first start having them
- Your blood tests show high levels of uric acid
How is gout treated?
There are a few medicines that can reduce the pain and swelling caused by gout. When you find one that works for you, make sure to keep it on hand all the time. That way you can take it as soon you feel a flare starting. Gout medicines work best if you take them as soon as symptoms start.
The medicines used to treat gout flares include:
- NSAIDs– This is a large group of medicines that includes ibuprofen and indomethacinNSAIDs might not be safe for people with kidney or liver disease, or for people who have bleeding problems.
- Colchicine– This medicine helps with gout but it can also cause diarrhea, nausea, vomiting, and stomach pain.
- Steroids– Steroids can reduce swelling and pain. These steroids are not the kind that athletes take to build up muscle
What can I do to prevent gout
Uric acid is formed when proteins in the food we eat, called purines, are broken down. Therefore, there has been a great deal of interest in the dietary management of gout by avoiding purine-rich foods. However, a diet very low in purines is extremely difficult to follow, because purines are a natural part of many healthy foods. Even when a diet very low in purines is followed strictly, the uric acid level in the bloodstream is only slightly lowered.
The following dietary principles are important in the management of gout:
- Gout is associated with obesity, and significant weight loss can dramatically improve the management of gout. A calorie-reduced diet is helpful for weight loss.
- A diet low in saturated fat, with increased protein and replacement of refined carbohydrates (for example, sugar, white bread, potatoes) with complex carbohydrates (such as vegetables and whole grains) reduces the serum uric acid.
- Decreased consumption of seafood and red meat.
- The consumption of low-fat dairy products decreases the risk of gout.
- Drinking beer and liquor increases the risk of gout. However, drinking wine does not appear to increase the risk of gout.
- In one study, consumption of fresh cherries was associated with a 35% decreased risk of gout. Some people believe that black cherry juice or dried cherries have the same effect, but this has not been proven.
- Drinking beverages sweetened with sugar or high fructose corn syrup increases the risk of gout.
With repetitive episodes of gout, there are options to take medication daily to prevent attacks.