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
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
than 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 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.