Gout is a form of arthritis that happens when urate crystals form in joints. It is sometimes called the “disease of kings,” because people incorrectly associate it with overindulgence in food and wine.
In fact, gout affects more than three million Americans, and can happen to anyone, rich or poor. It occurs when extra uric acid (a natural byproduct of the body) creates needle‐like crystal deposits in joints. Uric crystals attract white blood cells, which leads to severe, painful inflammation and arthritis. Uric acid can also cause kidney stones in the urinary tract (although this is not part of gout).
Certain foods (shellfish, red meats), beverages (alcohol, sugary drinks), and particular medications can raise uric acid levels in your blood. People with weak kidney function may develop gout, since their kidneys can’t effectively filter the uric acid out of the blood stream. Gout is also strongly linked to other common diseases -- obesity, high blood pressure, high cholesterol, kidney disease, and diabetes. It tends to run in some families, but rarely affects children.
Other forms of arthritis can mimic gout, so proper diagnosis can be tricky. For many people, initial attacks begin at night. Clues that you have gout include swelling and intense pain in one or two joints (at first), followed by pain‐free periods.
For a thorough diagnosis, make an appointment with one of our rheumatologists. The physician may extract fluid from a joint and study it under a microscope for signs of urate crystals. In more advanced gout, crystals are also found in deposits under the skin. A blood test cannot lead to an absolute diagnosis -- uric acid levels in the blood can sometimes be misleading, especially if measured during an acute attack.
There are medications you can take to avoid gout flares. If you have repeated bouts with the disease, high levels of uric acid in the blood, or kidney stones, our doctors can help to determine if you need medicines to lower uric acid levels in your blood. In almost all cases, treatment can bring a gradual end to attacks. But what works well for one person may not work well for another. Decision about when to start treatment and what drugs to use must be tailored for each person.
There are changes you can make in your life to reduce the risk of an attack of gout. Your choices about food can increase uric acid levels in your blood. Limiting the amount of high-fructose drinks, such as sugared soda, can help. Beer should also be limited or excluded from your diet. Foods high in purines (compounds that break down into uric acid) like red meat and certain types of seafood should be reduced. Low‐fat dairy products may help to lower uric acid levels. Weight loss and exercise may make it easier to manage this lifelong disease. Your treatment plan may be complicated by other illnesses and medications. As experts in the field of arthritis, our rheumatologists can help you to understand the best route for your long-term well-being. Make an appointment to learn how we can help with diagnosis, treatment, and management.Contact Us Today