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Gout

What is it?

Gout is a disorder that involves elevated levels of uric acid in the blood. The crystals from the uric acid then settle from the blood stream into various joints of the body, and most commonly, the big toe joint. Gout is a chronic disease that begins with recurring attacks. When an attack develops, it can last several days and the joint becomes swollen, red, and extremely painful. Patients often complain of not being able to tolerate a sheet resting on their big toes or other parts of their feet such as their heels or even their ankles. The foot is commonly affected because it is subjected to continued pressure in walking, increased exposure to trauma, and its greater tendency for anatomic blood pooling to occur.

What causes it?

Gout is a metabolic condition that is somewhat common in the general population. Men in their 4th to 5th decades of life suffer from gout seven to eight times more often then women. There is also genetics involved with this certain disease and if someone in your family suffers from this condition, you are at an increased risk for developing this disease. Alcohol tends to worsen this condition and trigger more frequent attacks. The use of diuretics or 'water pills' can also trigger the settling of uric acid in the blood and can lead to frequent episodes of painful gouty attacks.

How is it treated?

The treatment of gout usually begins with reducing the pain and swelling by keeping the patient off weight bearing and to elevate and rest the affected area. Anti-inflammatory medications help to reduce the pain and swelling and also help to remove the uric acid from the body. Steroid injections into the joint also aid in the reduction of pain and swelling. The avoidance of alcohol and foods that contain high levels of protein is advisable to prevent gouty flare-ups. Drinking a lot of water is also suggested to dilute the levels of uric acid in the body. Once a patient develops gout and has had recurrent episodes, preventive oral medications can be taken to prevent and/or minimize future attacks. Surgery should be considered only when all other forms of treatment have failed. The surgery itself, would involve a remodeling of the affected joint or joints.



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