Gout is sometimes called the “Disease of Kings,” after some famous sufferers in history such as England’s Henry VIII. Rest assured, however, that gout is experienced by all manner of Canadians – with or without regal bloodlines – and it is not caused by overindulgence in and of itself.
Regardless of its names or connotations, one thing is certain – gout is painful and something best avoided. The following is a primer on gout, including what it is, what to do if an attack occurs and how best to prevent it.
What causes gout?
Gout is a painful form of arthritis that develops when blood becomes oversaturated with uric acid. Buildup of this acid causes the development of crystals in and around joints, resulting in intense inflammation.
Uric acid is a breakdown product of the substance purine, which is present in your body’s tissues and also found in many foods. Normally the kidneys excrete uric acid through urine, but buildups occur when the body can’t rid itself of enough of it due to factors such as genetics, certain drugs, kidney disease or increased intake of purine-containing foods.
Not everyone who has high uric acid develops gout, but everyone who has gout has had elevated uric acid levels at some time. These elevated levels also tend to be associated with cardiac risk factors such as high blood pressure, obesity, diabetes and adverse cholesterol profile.
What happens when a gout attack occurs?
The first attack of gout is usually in the big toe – and it hurts!
Known as Podagra, this first instance of gout is extremely painful, and you’ll want to make an appointment with your healthcare provider right away for treatment. Ideally, identification of uric crystals in joint fluid is used to make the diagnosis. If this isn’t possible, an imaging modality called Dual Energy CT scan can identify uric acid crystals in the tissue.
Typical attacks of gout last 7-10 days and are usually treated with anti-inflammatory drugs. After the episode subsides, the disease enters the intercritical period, during which there are no symptoms. However, most patients will experience a second attack of gout within two years, after which point attacks may become increasingly frequent.
How to manage an acute attack of gout
Start your prescribed anti-inflammatory medication as soon as possible after gout symptoms begin, and take it regularly until a few days after symptoms subside. (If anti-inflammatory medication isn’t appropriate for you, your doctor will provide alternate medication.) Don’t use aspirin to treat your gout attack – it can exacerbate the symptoms! Icing and elevation of your sore joint can help ease the pain.
How to avoid gout and prevent recurrent attacks
If you’ve had an episode of Podagra, you’ll want to do everything possible to prevent another painful occurrence.
Lifestyle choices are important; here are a few tips for warding off gout:
- Lose that extra weight
- Keep your intake of purine-containing foods, such as meat and seafood, moderate
- Emphasize low-fat dairy products, which are protective
- Decrease consumption of alcohol, sugary juices and sodas
- Consider a small supplement of vitamin C
- Drink plenty of water
- Eat cherries if you like them – they help!
Additionally, any medications you’re on may need tweaking. Low-dose ASA (aspirin) 81 mg is fine, but higher doses can aggravate. Diuretics (water pills) used to treat high blood pressure decrease the ability of the kidneys to excrete uric acid, so alternate medication may be appropriate.
If you’re experiencing two or more acute gout episodes per year and lifestyle measures don’t make an impact, your doctor will likely recommend the use of prophylactic medication.
The disease of kings may sound regal, but gout is no fairy tale. Don’t despair if you’ve suffered from it in the past, however; effective treatment is available to bring gout to heel.
If you are exhibiting symptoms of gout, please book an appointment as soon as possible with your Copeman physician for a diagnosis and treatment plan.
Uric acid is considered an indicator of cardiovascular health risk and is now routinely measured during your annual prevention screen to help assess your risk for cardiovascular disease*.
*as medically indicated.