Patient Education

GOUT

Gout is a recurring form of inflammatory arthritis that most commonly affects the big toe joint but may affect other joints such as the midfoot and ankle.

Gout

Causes

Gout is caused by the build-up of uric acid. Uric acid is a natural substance found in the body and in foods such as organ meats, mushrooms, and anchovies. The kidneys eliminate uric acid in urine. A build-up of uric acid can occur if the kidneys do not remove enough of it (90% of gout cases) or if the body overproduces it (10% of gout cases). An excess of uric acid forms urate crystals which is deposited in joints and surrounding tissues causing pain and inflammation.

Symptoms

Gout usually begins with a sudden onset of pain usually at night. It usually affects one joint, most commonly the big toe joint. Other joints can be affected such as the midfoot and ankle joints. Symptoms include pain, swelling, redness, and increased warmth to the foot.

Risk Factors

Men between the ages of 40-50		High cholesterol
Women after menopause		Diabetes
Gout can be hereditary		Arteriosclerosis
Consuming alcohol		Low-dose aspirin
High blood pressure		Thiazide diuretics
Renal impairment		Thyroid problems
Obesity		Exposure to lead
Pts who have had organ transplants

Triggers

Overeating purine-rich foods		Stress
Binge drinking alcohol, particularly beer		Sudden weight loss
Joint injury		Surgery
Strenuous activity		Severe illness or infection

Certain medications including water pills, low-dose aspirin, Cyclosporine, and Levodopa

Foods to Avoid

Liver		Lamb
Kidneys		Herring
Anchovies		Canned Tuna
Sardines		Shrimp
Meat Gravies		Lobster
Beef		Scallops
Pork		Mussels

Treatment

Gout is treated with medications to relieve pain and inflammation, such as non-steroidal anti-inflammatory drugs, Colchicine, and steroids. Your doctor may prescribe medications to decrease uric acid production in your body or to help your body remove uric acid. Avoid foods that are high in purines and limit the amount of protein from meat that you eat to about 5-6oz/day and avoid drinking alcohol.
Drink plenty of water to help the kidneys eliminate uric acid

Complications

Left untreated, gout can lead to advanced gout which is associated with nodules of urate crystals under the skin called tophi and joint damage. A build-up of uric acid can also cause kidney stones.