What is gout?
Gout is a painful form of inflammatory arthritis caused by high uric acid levels in the body. It is most common in men over the age of 40, and in post-menopausal women. The first attack of gout often occurs in the big toe and is characterized by redness, swelling, joint stiffness and significant pain.
Gout is treatable but can be recurring, within weeks, months or even years between attacks.
The first attack of gout commonly occurs in the joints of the big toe, but it can also affect other parts of the foot including the heel and smaller toes, along with the knees, fingers, wrists and elbows. As gout reoccurs, you may find that it presents in different parts of the body.
Gout presents with swelling and pain in joints throughout the body, primarily in the big toe.
Regardless of where gout strikes, the symptoms include:
- Warmth at the infected site
- Extreme tenderness
- Joint stiffness
A build-up of uric acid and/or a diet rich in purines can cause gout.
Gout is caused by a build-up of uric acid in your blood, an occurrence called hyperuricemia. When the acid builds up, sharp urate crystals form on tender joints causing swelling and tenderness to the surrounding tissue.
Uric acid comes from purines, which are substances found in the body tissue, but they can also come from food including organ meat, anchovies, dried beans, asparagus and mushrooms, to name a few. Thus, eating a diet rich in purines can also cause gout.
Typically uric acid dissolves in the blood, passes through the kidneys, and is expelled from the body in urine. Build-ups develop when the body produces too much uric acid, or the kidneys get rid of too little.
Treating gout is dependent upon over-the-counter medications.
Doctors can diagnose gout by looking for high uric acid in the blood, asking about symptoms, observing the affected site, and looking at past personal and family medical histories. To confirm the diagnosis, doctors may draw fluid from the joint to look for uric acid crystals.
Medications to treat gout may include one or more of the following:
- Non-steroidal anti-inflammatory drugs (NSAIDS): Prescription strength or over-the-counter NSAIDS like Advil, Motrin, or Aleve may initially be given in high doses to control the pain and swelling of an acute gout attack, then in lower doses to keep attacks from recurring while managing pain.
- Corticosteroids: Prescribed to control pain and swelling. May be given in pill form or injected directly into the affected site.
- Colchicine: May be prescribed to relieve pain for patients who are not able to take anti-inflammatory drugs. Colchicine can often cause significant unpleasant side effects including nausea, vomiting and diarrhea.
Focusing on a gout-friendly diet of alkaline foods can greatly reduce risk and management of gout.
To control the pain of a gout attack, some patients use deep breathing exercises to calm their bodies and redirect their focus.
However, a more common and popular home remedy includes the consumption of cherries and vitamin C, both of which have been known to reduce uric acid levels in some patients. The key take away there – managing a healthy gout-friendly diet has proven successful as an alternative treatment of the ailment. This can require the reduction alcohol and purine foods (organ meat, anchovies, dried beans, asparagus and mushrooms) and the increase of alkaline foods (apples, berries, squash, sweet potatoes, almonds, green tea, quinoa, and goat cheese).
Drinking coffee may prove as a successful way to manage or prevent gout. According to research in 2016, those who drank four or more coffees a day were more likely to have lower uric acid levels in the blood, which is the cause of gout.
Important Note: Alternative treatments should be used in conjunction with, not in place of, traditional therapy for gout. A doctor should always be consulted before taking supplements or combining with other medication.
Gout can be prevented with proper diet and weight management.
Studies suggest that some cases of gout can be prevented with proper lifestyle changes including diet, exercise, weight loss, and lower alcohol consumption.
Other specific preventative measures for gout include:
- Increase hydration (8 -16 cups per day)
- Eat a well-balanced diet with high complex carbohydrates, lean protein and low-fat dairy products
- Exercise at least moderately
- Maintain a healthy weight
- Limit purine-rich foods/beverages including beer, mushrooms, cauliflower, anchovies, yeast, meat extract, gravies
- Eat foods that are known for their anti-inflammatory properties including dark berries, salmon, flax, olive oil and nuts