How to Diagnose and Treat Gout
Gout sends almost 4 million people to the doctor’s office every year. If you are overweight, drink alcohol, or are under treatment for high blood pressure, you are at risk. But what is it and how can you prevent it? House Call Doctor explains.
Gout is a fairly common medical condition that sends almost 4 million people to the doctor’s office every year. If you are overweight, drink alcohol, or are under treatment for high blood pressure, you are at risk for gout. You may have heard of this rather mysterious medical condition – you may have even heard it referred to as “the disease of kings” – but what exactly is it? And how can you be sure that it never happens to you?
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What Is Gout?
Gout occurs when uric acid crystals develop as a by-product of the metabolism of certain proteins (called “purines”) consumed in our diet. These crystals attack and set up shop in our joints. That doesn’t sound comfortable, does it? Well, it certainly isn’t. Patients with an acute gout attack often describe their experience as:
- Sudden onset of pain in one joint (it’s possible for gout to occur in more than one joint at a time, but that’s less likely)
- The joint is described as “hot” or “burning”
- Pain is severe in intensity
- There’s redness and swelling at the site
- The joint may be warm to the touch
- The attack is not precipitated by any trauma
Basically, gout is a very severe joint pain that seems to just come out of nowhere. The first episode of gout most often happens in the big toe; future attacks may affect other joints, but are much more common in the lower extremities (feet, ankles, toes, or knees).
Who Gets Gout?
Gout is certainly more common in older patients, but I’ve actually seen very young patients afflicted as well. With the prevalence of obesity, the frequent consumption of alcohol at social events, and an aging population with more chronic medical conditions, gout is becoming more and more common.
Certain patients have a higher risk of developing gout, including those with:
- Obesity or excess weight
- Hypertension
- Diabetes
- Heart disease
- Kidney disease
- Alcohol abuse
- Receiving chemotherapy treatment
I’ve discussed most of these risk factors in more detail in my prior episodes – so make sure to check them out and learn how to take charge of your health.
Now that you know what gout is, the next step is to figure out how to treat it.
What Happens if You Don’t Keep Your Gout in Check?
About 60% of people who have an acute gout attack will have another one within one year – that’s a pretty high chance. In patients who get recurrent gout episodes, the uric acid crystals can deposit into various body parts and cause the following complications: arthritis, kidney disease, kidney stones, masses or nodules called “tophi” that can occur on the outside of the ear, elbows, hands, knees, and other soft tissues. These can erode the underlying joint over time and lead to complications.
Therefore, it’s vital that you learn how to prevent future gout attacks.
How Can You Prevent Gout?
Since the risk of having more gout attacks increases by 60% after you have one, it’s highly recommended that you follow certain measures to prevent recurrence. Here are 5 tips to help decrease your risk of future episodes:
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Lose weight: People with a body mass index (BMI) of over 25 are at a higher risk of developing gout. Therefore, your first goal of action should be to lose weight – even a 10% weight loss would be beneficial. Maintain a low carb, low fat diet, and engage in at least 30 minutes of continuous cardiovascular exercise on most days of the week. Check out the Quick and Dirty Tips Weight Loss page for more tips on shedding extra pounds without going hungry.
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Change your diet: Besides learning to keep a well-balanced, well-proportioned diet to lose weight, a diet low in what we call “purines,” a type of protein, is also helpful. Cutting them out altogether may not be feasible, but if you tend to overdo it on these products, it would be wise to cut down. Try decreasing red meat and seafood protein sources, while concomitantly increasing protein from low-fat dairy products (which seem to actually decrease your risk of gout). Also, cut out all drinks with sugar and minimize sweets. See also: How to Reduce Your Added Sugar Intake
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Minimize alcohol consumption: Alcohol is not only fattening, but it also increases your risk for gout. In a recent study, men who drank more than 2 beers a day had a 2.5 fold increase in their risk of developing gout. Smaller amounts of wine (less than two 5 oz glasses a day) have a lower risk of triggering gout attacks than beer. Beer seems to be the worst offender, but any alcohol can pose a risk.
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Review your medications: Certain medications, particularly diuretics used to treat high blood pressure, can precipitate gout in some patients. Although at low doses, they may still be deemed beneficial. Discuss this with your doctor.
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Take preventative medications: There are prescription medications that can be used to prevent future gout attacks. But they are meant to be taken daily and consistently, and are prescribed typically to patients with more than 2 attacks per year. It also tends to be for patients who cannot significantly reduce their risk via the previous 4 tips.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Big toe gout and fat belly images courtesy of Shutterstock.
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About the Author
Dr. Sanaz Majd is a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. Her special interests are women’s health and patient education.
