Gout

Viewer JEFF writes:

My workmate Dave left work...with extreme pain in his leg. Turns out he has Gout. Normally this condition is thought of only occurring in older folks, however Dave is 35. Looking into the causes of Gout, there seems to be some explanation: soda and alcohol consumption, a tad overweight and a diet of high protein… all potential causes of Gout. Maybe others would be interested in knowing more about his condition and treatment.

Dear Jeff,

Gout is a condition that affects a million Americans. Benjamin Franklin supposedly had it. It's a type of arthritis that gives you sudden attacks of pain and redness in the joints.

Gout is nine times more common in men than in women. It predominantly attacks males after puberty, with a peak age of 75. In women, gout attacks usually occur after menopause.

Gout usually affects the large joint of your big toe. Other joints that can be affected include the ankles, knees, wrists, fingers, and elbows. Untreated, the pain can last 5 to 10 days, and then subside over the following two weeks. People can have recurrent attacks. Chronic gout can lead to deposits of hard lumps of uric acid in and around the joints, decreased kidney function, and kidney stones.

The condition comes from sharp, needle-like uric acid crystals building up in the joint. Your body makes uric acid when it breaks down substances in your own body, as well as when it breaks down certain foods, such as anchovies, herring, asparagus, and mushrooms. Normally uric acid dissolves in the blood and gets eliminated through the urine, but too much build-up or not enough elimination can lead to the problem.

Risk factors include family history, water pills, certain medical conditions (high blood pressure, high cholesterol, hardening of the arteries), and more than two alcoholic drinks a day. Joint fluid tests and blood tests can help with the diagnosis. Medicines can alleviate symptoms during an attack, and long-term preventive medicines can be taken if attacks are frequent or severe. Adjusting the diet can help, too: cutting back on red meat and seafood, eating whole grains and low-fat dairy, and avoiding alcohol.

You should seek medical care immediately if you have a fever, or if the joint is hot and swollen.

Hope this helps!

Dr. Maria

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