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Gout Gout
Gout is a condition that occurs when there is too much uric acid in our body. Gout has been one of the most... Gout

by Kimberly Allen R.N.

Gout is a condition that occurs when there is too much uric acid in our body.  Gout has been one of the most frequently recorded medical conditions through out history.  The number of cases of gout has doubled since 1990.  Most experts believe gout affects approximately 2% of the western population, including over 6 million Americans.  Men 30 years of age and older as well as women 50years and older have a greater chance of developing gout.  Also, a recent study showed that African Americans are twice as likely to develop gout than European Americans.  Other factors that are believed to play a role in the development of gout include genetics, you have a 20% chance of developing gout if your parents have it,  nutrition, foods high in uric acid content contribute significantly to gout.  Alcoholism and obesity can also significantly impact your bodys ability to excrete uric acid.

Gout is caused by a buildup of uric acid in the joints.

Gout occurs when uric acid builds up causing urate crystals to form and build up in your joints.   Our body naturally produces a certain amount of uric acid and we take in uric acid when we eat certain foods.  Uric acid normally dissolves in our bloodstream then is filtered through the kidneys and excreted in urine.  When our body produces too much uric acid or the kidneys are unable to excrete enough uric acid there is a build up of uric acid in our body.  Approximately 10% of people with gout are considered ‘over producers’ of uric acid while the remaining 90% are considered ‘under excreters’ meaning they are unable to effectively eliminate uric acid in their urine.  Once the uric acid  crystals have formed in your joints it becomes a chronic condition known as gouty arthritis.  Gouty arthritis is not only chronic it is also progressive.  it can eventually lead to joint destruction as well as impaired kidney function and kidney stones.
Frequently the symptoms of gout will appear suddenly without warning.  Many people with gout state their symptoms started at night though there is no scientific explanation for it.  The most common symptom of gout is severe pain.  Usually gout affects your big toe first but it can be in other joints of your feet and ankles as well as those of your hands and wrists.  Usually the pain will lessen to more of a constant ache after the first 24 hours of it’s your first attack.  Later attacks tend to be more painful for longer periods of time.  The joint(s) that are affected usually become red, swollen, as well as warm and tender.
There are numerous medications that can be used to treat gout as well as recurrent gout attacks.  Over the counter medications like NSAID’s are used to decrease inflammation and relieve pain.  In some cases of severe attacks your Dr may prescribe a stronger NSAID like indocin.  However, it’s important to remember the stronger the NSAID the greater the potential for complications like stomach pain and bleeding even ulcers.  Some people are unable to take NSAID’s  for those the Dr may prescribe a medication calledcolchicine though this medication is effective in relieveing the pain of gout the side effects can be intolerable like severe nausea and vomiting as well as diarrhea which increase your risk of becoming dehydrated.  Other medications like prednisone are also frequently given to decrease inflammation and pain.  However, the side effects of long term use of prednisone can be serious including impaired immune system, slow healing and thinning bones.  Post menopausal women have a much higher risk of developing osteoporosis if on long term prednisone therapy.  For those people that tend to have several attacks of gout a year the Dr may prescribe medications that block the production of uric acid, the most commonly used medication being allopurinol.  In addition to medications your Dr will discuss the dietary changes that you should include in your treatment plan.  Those would include staying well hydrated by drinking 8-16 cups of fluid everyday, at least half of which needs to be water and avoid alcohol.  It’s important to also limit the amount of red meat especially avoiding organ meat, with fish and poultry being no more than  4-6 ounces a day.  Try to get your protein from other healthier sources like tofu, low fat or fat free dairy, eggs and nut butters.
The best way to prevent gout is to stay hydrated and limit those drinks high in fructose corn syrup.  Avoid or limit your alcohol intake, especially beer as beer has been associated with increased incidence of gout especially in men.  Eat a well balanced diet that is high in fresh fruits and vegetable, whole grains  and low fat or fat free dairy products while avoiding organ meats and red meats.  Exercise and maintaining a healthy body weight are also crucial to preventing not only the onset of gout but recurrent attacks.

Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at mussatti3@gmail.com.

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