Dealing with the painful effects of gout

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Gout often causes severe pain in the big toe but can also affect other joins in the body.

Gout is a disease characterized by recurrent attacks of arthritis, in which uric acid appears in excessive amounts in the blood and may be deposited in joints, tendons and other tissues.

Excessive levels of uric acid occur in the blood of between 10% to 20% of the adult population, however, gout occurs in about three out of every 1,000 people.

Ninety-five percent of individuals with gout are males over the age of 30. Gout occurs infrequently in females. The exact cause of gout is not entirely known. It is a disorder of the metabolism of purines. Purines are nitrogen-containing substances found mainly in high protein foods. The net product of purine breakdown is uric acid.

Uric acid is normally expelled from the kidneys in urine. With gout, however, the uric acid is retained in the blood in excessive amounts. The high amount of this acid is then deposited in joints and tendons throughout the body. In some cases, crystals can precipitate forming swollen lumps called “tophi.” The uric acid crystals can also predispose to the development of kidney stones and can cause kidney damage.

Other factors associated with the development of gout include obesity, hereditary diseases such as Down’s syndrome, glycogen storage disease, decreased kidney function, hyper and hypothyroidism, high blood pressure, atherosclerosis, high triglycerides and excessive exercise.

In the Middle Ages, gout was considered a disease of the wealthy caused by overindulgence of rich foods like meat and pastries, as well as alcohol.

Gout is a Latin word meaning to drop, as it was believed to be caused by a drop in the body’s humours. Besides diet it was is believed to be precipitated by fatigue, emotional stress, minor trauma, surgery, infection and the administration of penicillin, insulin or diuretic drugs. The acute form of gout usually begins suddenly without warning. Seventy percent of attacks involve the big toe, although other joints, including in the ankle, foot, foot, knee, wrist and elbow can be involved.

Throbbing, crushing and excruciating pain of the affected joints can occur. Individuals suffering from gout may be bedridden or have difficulty walking due to the pain. Swelling, tenderness and inflammation of the overlying skin can result. The skin may be a hot, a shiny dusky red or purple colour. A slight fever, rapid heartbeat, headache, chills and malaise can also be associated with gout.

The first attack of gout lasts a few days to several weeks. The symptoms usually disappear until the next attack. As the disease progresses, attacks tend to last longer and the interval between attacks become shorter.

If left untreated, a chronic form of gout can develop and persist for many years and a decreased range of motion and joint deformation can result. In 10% to 20% of individuals with chronic gout, damage to the kidneys occurs as a result of kidney stone formation.

Conventional medical treatment of gout focuses on drugs or surgery to alleviate symptoms associated with this disease. Drugs used include colchicine, allopurinol, indomethacin, prednisone and other corticosteroids. Surgery on the affected joints is occasionally performed when conservative therapy fails.

Stress can also aggravate attacks of gout. Stressors should be identified and reduced. Exercise, meditation, yoga and biofeedback can help to reduce stress. Aspirin and salicylate pain drugs should be avoiding as they antagonize the excretion of uric acid from the kidneys.

A diet low in purines is strongly recommended for this with gout. Avoid foods high in purines, such as meats, especially processed meats, organ meats and seafood, beans, legumes and peas. Decrease consumption of alcohol, especially beer. Decrease all refined carbohydrates with added sugar, including fructose or fruit sugar. Avoid pop and other sugary beverages. Reduce coffee and tea. Increase consumption of fresh fruits and vegetables and unprocessed, whole foods. Also, increase consumption of water to at least six to eight glasses per day, unless you are on a medical fluid restriction. Alkalizing the blood and urine with baking soda or sodium bicarbonate can be beneficial and adding apple cider vinegar or lemon juice can also be beneficial.

Increasing consumption of dark berries as a juice or as a whole food is helpful. Blackberries, blueberries and cherries can be useful in eliminating uric acid. Increase consumption of natural diuretic foods will aid in the elimination of uric acid through the kidneys. Foods to emphasize include celery, parsley and watermelon.

The drug colchicine was first isolated from a plant called Meadow saffron. Colchicine is a drug of choice in treating gout attacks. The content of colchicine in Meadow saffron is not standardized and consumption of the plant is strongly discouraged. Other herbal anti-inflammatories, including Boswellia, bromelain, ginger, turmeric, pancreatic enzymes can be taken. Herbal diuretics, including bearberry, birch and cornsilk, can also be helpful.

The information provided in this article is not intended to constitute medical advice. All information and content are for general information purposes only.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.