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What is gout?
Gout is an acute form of arthritis caused by the deposition of uric acid crystals in a joint, tendon or soft tissues. Gout has been with humanity for thousands of years. It is the most common form of inflammatory joint disease in men over the age of 40. It is estimated to affect 0.5–2.8% of men, with a lower rate of occurrence among women. The elevated uric acid levels that lead to gout can also lead to kidney stones.
What are the symptoms of gout?
A classic attack of gout is to wake up one morning with a red, swollen, hot and acutely painful big toe. While the base of the big toe is the most common target, the ankle, instep, knee or wrist could also be involved. There are a couple of ways to diagnose gout. If the person has a painful big toe, where it is often difficult to obtain joint fluid, a diagnosis can be made by the presence of a high blood uric acid level.
What causes gout?
Purines in foods that we eat are metabolized by the body into uric acid. Normally, uric acid levels in the blood are maintained at levels that will not lead to gout. If an individual has a genetic predisposition or a diet high in purines, their body produces too much uric acid, or their kidneys do not excrete enough of it, it can build up in the blood, increasing the risk of urate crystals forming and causing an acute attack of gouty arthritis.
What treatments are available?
For those with a propensity for gouty arthritis, some dietary changes can help:
- Avoid alcohol, anchovies, sardines, oils, herring, organ meat (liver, kidney and sweetbreads), legumes (dried beans and peas), gravies, mushrooms, spinach, asparagus and cauliflower.
- Limit how much meat you eat.
- Avoid fatty foods such as salad dressings, ice cream, pizza and fried foods.
- If you are losing weight, lose it slowly. Quick weight loss may cause uric acid kidney stones to form.
Medications that help with gout are anti-inflammatories such as colchicine, ibuprofen, naproxen, etc. To avoid gouty arthritic attacks, medicines like allopurinol and/or probenecid can help.
What research is being done to help gout sufferers?
At Baptist Health Center for Clinical Research, we routinely perform clinical trials on novel therapies to decrease the frequency and severity of gout attacks. Some of the newer research involves the use of human monoclonal antibodies.