Gout, or gouty arthritis, is a painful and often debilitating condition that commonly affects the foot and ankle. According to the American College of Rheumatology, gout is the most common form of inflammatory arthritis and affects approximately 9.2 million adults in the United States alone. It is caused by a build-up of uric acid that may be deposited in joints and cause pain, redness, and swelling. Uric acid itself is a chemical created when the body breaks down certain substances called purines. Therefore, a high purine diet can lead to elevated uric acid and ultimately the development of gout. Foods that are high in purines include red meat, cheese, shellfish, and alcohol. It is for this reason that gout was historically referred to as “the disease of kings.” Uric acid can also accumulate within the body if the kidneys fail to excrete an adequate amount of uric acid.
Gout often presents as pain, swelling, and redness within or around a joint. It has a predilection for the foot and more specifically the great toe joint, but can affect any joint within the body. The symptoms tend to occur suddenly, without any trauma or inciting factor. Gouty pain occurs as an acute “attack” of severe pain that may then taper down slowly over the next few days. Individuals who have 1 attack of gout are predisposed to having future attacks.
The diagnosis of gout is often made clinically – a doctor can make the diagnosis by taking a complete history and performing a physical exam. X-rays are often obtained, as a prolonged history of gout can cause radiographic changes. Afterall, gout is a form of arthritis. Some doctors may order a uric acid blood test to see if the individual has excess uric acid, or they may order a kidney test to see if the body is able excrete the uric acid that the body produces naturally. However, a normal result of these tests does not rule out the diagnosis of gout.
Luckily, there are multiple effective ways to manage gout. By avoiding foods that are high in purines, one can prevent the buildup of uric acid and thus prevent a gouty attack. Additionally, drinking plenty of fluids can help the kidneys to excrete uric acid from the body. Anti-inflammatory medications such as Colchicine and Indocin help to treat the pain and inflammation associated with gout. During a severe attack, a doctor may administer a cortisone shot into the affected joint. If a patient has suffered multiple gouty attacks despite these interventions, they may consider taking medication such as Allopurinol that prevents the formation of uric acid within the body.
Gout is preventable and treatable, so if you experience any of the symptoms mentioned above, please do not hesitate to make an appointment in one of our offices for consultation.