You wake up to a throbbing pain in your big toe. You feel like it’s on fire. Even the touch of the bedsheet drives pangs of agony from your swollen, hot, tender joint. There’s little doubt; you have gout.
Gout is inflammation of a joint caused by uric acid crystals. When these crystals deposit in the joint or soft tissue they cause irritation, swelling, heat, pain and joint stiffness. It’s like that friend who insists on putting lots of sugar in her tea. When you pick up the cup you notice the white crystals at the bottom. Too much uric acid causes the crystals to settle, thus causing pain and inflammation. While gout can affect any joint, it most commonly affects the large toe (this is called Podagra).
Anyone can develop gout, but there are risk factors which increase the likelihood. People with family history may be more likely to experience an attack as genetics play an important role in our ability to clear uric acid from the body. Similarly, it is more common in adult men. Being overweight increases the risk of developing gout; so does drinking too much alcohol. In fact, alcohol interferes with the removal of uric acid from the body.
Renal insufficiency, or the inability of the kidneys to eliminate waste products, is a common cause of gout in older people. Other medical problems that contribute to high blood levels of uric acid include: thyroid disease, psoriasis, certain types of cancers and high blood pressure.
Some medications can also increase the incidence of a gout attack: diuretics (often called water pills), low dose aspirin, niacin, cyclosporine and levodopa for examples. Foods rich in purines, which are the building blocks of uric acid may raise these levels. Purine-rich foods include certain seafoods and red meat. Fructose found in soft drinks may also increase amounts of uric acid.
Treatment for gout is twofold: treat the acute or immediate attack and prevent further attacks. Acute treatment most often involves prescription of non-steroidal anti-inflammatory drugs (NSAIDs) such as indomethacin. NSAIDs carry the risk of increased bleeding and stomach irritation. Colchicine, which also helps, is a medication derived from the meadow saffron plant that has been used since 1500 B.C. It is most effective if given early but is limited due to its side effects of nausea and vomiting.
Non-pharmacological treatments include: rest and ice as well as increased fluid intake and avoiding alcohol. Therefore, hardcore partying is not a great choice! So, recognize the signs and treat early and we have you up and dancing in no time. Take care of yourselves and each other.
