What is Gout?
Gout is an arthritic condition in which we have an excess amount of uric acid in our body. When we have large amounts of uric acid, the uric acid can form crystals that deposit typically in joint spaces but can also occur in tendons. When this occurs, the affected area may become very painful.
What causes Gout?
When we have an excessive amount of uric acid in our body this means either our body (kidney) is not getting rid of the uric acid efficiently or not breaking it down effectively. Uric acid is a byproduct from the breakdown of purines. Here are some reasons/contributing factors as to why we develop gout:
- Some medications such as certain diuretics and low dose aspirin
- Diet in heavy in food and beverages containing purines (alcohol, red meat, shellfish, organ meat)
Of note, gout is more common in men. People with high blood pressure, obesity, kidney disease, and diabetes may be more prone to developing gout.
What are the symptoms of Gout?
- Severe pain usually localized to one joint (most commonly we see this in the great toe)
- Warmth at the affected joint
- Often gout attacks begin when sleeping, and patient wakes up with severe pain. We often hear even bedsheets touching the foot cause pain.
- If gout is chronic, there is a possibility for the development of a soft tissue mass. These are called tophi and are large deposits of crystals.
How to diagnose Gout?
Gout is typically suspected clinically when we have a patient that presents to the clinic with a red, hot, swollen foot that is in severe pain with no history of recent injury. We may order a blood test to check your uric acid levels. We will also take xrays to ensure no damage to the affected joint. We may also attempt to draw fluid out from the joint using a needle to send to a lab for analysis.
How to treat a Gout attack?
- NSAIDs, especially stronger ones such as indomethacin
- Colchicine is another oral treatment option
- Oral steroids can help ease symptoms
- Depending on the severity, a cortisone injection into the joint is an option
- Avoiding alcohol, red meat, shellfish
- There are also medications that help reduce uric acid levels and prevent gout attacks
- If a large tophi develops, there is a chance for the need for surgery.
How to prevent Gout?
- Limit consumption of red meat, organ meats (liver for example), alcohol, and shellfish
- If you have recurrent gout attacks speak with your primary or podiatrist for prevention medication
- Stay hydrated
If you have symptoms consistent with gout or a history of gout and have concerns, please click HERE to schedule an appointment at Star Foot & Ankle Specialists.