Gout is an extremely painful, inflammatory condition that commonly affects the joints of the large toe, but can affect any joint. About two percent of all Americans experience gout; however, approximately twice as many African Americans (three to four percent) suffer from gout. Chronic gout can cause joint deformity and joint destruction.
What causes gout?
Gout is caused by the build-up of uric acid crystals that get deposited in joints, producing an intensely inflamed and painful joint response. Over time, the crystals can build up to a paste-like material called tophi.
Uric acid comes from the breakdown of certain products in our bodies called purines, and also from foods that are rich in purines such as high fructose corn syrup, red meats, seafood, certain vegetables (such as beans, peas, lentils and spinach), and alcohol. Gout can be caused either by the inability to get rid of purines or by an increased production of purines within the human body.
Certain medications can also increase the incidence of gout such as low-dose aspirin, diuretics for blood pressure, and medications used for patients with organ transplants. Additional factors that can cause gout are having high lipid levels, being overweight, having high blood pressure, and diabetes.
How is gout diagnosed?
The diagnosis of gout is made by examining the fluid of the inflamed joint under a microscope to see the characteristic crystals.
How is gout treated
Gout is treated with anti-inflammatory medications such as Indomethacin. Additionally, gout can be treated with steroids. These are used for acute attacks. There are certain medications that can reduce uric acid levels and prevent future gout episodes.
Another thing you can do is drink plenty of water, maintain an appropriate and healthy weight, and minimize foods that can cause a gout attack. By limiting intake of such foods, taking medications prescribed by your doctor to prevent gout, and by also managing hypertension, high lipid levels, and diabetes, one can go a long way in preventing future gout attacks. Physical fitness and products such as coffee and vitamin C also appear to decrease the risk of developing gout.
If you have a gout attack, contact your physician immediately, especially if you are experiencing fevers or chills, to make sure there is not an accompanying joint infection. Also, talk to your doctor about several medicines used to prevent gout attacks.
If you have gout, make sure you are seeing a doctor on a regular basis and are having your uric acid levels checked. Make sure you take your medications exactly as prescribed by your doctor, maintain a healthy weight, keep diabetes under control, keep blood pressure under control, minimize alcohol consumption, and minimize foods that are rich in purines that can cause a gout attack.
Also, anytime uric acid levels change a gout attack can or may occur. If you are treating your gout, don’t give up. You still may have an attack or two as your uric acid levels become normalized. Talk to your doctor about a treatment plan to get you through this transition period, and also a back-up plan for any future attacks of gout.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.