If you have ever had or know somebody who has had gout, you know what a painful condition it can be.
Describing it as having your foot on fire is not an exaggeration. In fact, The Greek Physician
Hippocrates called it the unwalkable disease for a good reason. In this video we are going
to help you recognize this painful condition and find ways to help you overcome it.
Gout has been a condition that has been known about since ancient times.
It was referred to as the disease of kings because it was associated with a lifestyle
that throughout history could only be afforded by the most affluent. In a twisted way,
it was even a desired condition by some because of the status that it meant you had.
Gout is a condition that most commonly presents with a rapid onset of pain,
redness and swelling of your joints. The most common spot for it to affect is your big toe,
but it can occur in any joint. The pain is most severe in the first 12-24 hours after it begins
but then can last for up to two weeks or more if you don t treat it.
Gout is caused when a byproduct of metabolism called uric acid builds up in the body and then
accumulate in the joint. At some point due to varrying reasons, the uric acid then preciptates
or turns into crystals inside your joint. If you can imagine, it s like all of a sudden,
pieces of glass appear inside the joint that you depend on to walk. It is absolutely miserable and
if it happens to you, it s a great time to get into your doctor to get some help.
Uric acid, is formed when your body breaks down a substance called purines.
These are found naturally in your body and are found in high levels in certain kinds of foods.
Most people do just fine dealing with uric acid because your kidney s are pretty good at filtering
it out. . But in some lucky people, they either produce too much or their kidney s don t do a very
good job of filtering it out. When this happens (bomb/Fire effect on foot) Those crystals can form
and then you are in pain. But how do you know it s gout?
Just because you have a painful toe, it doesn t mean that it is gout.
There are other things that can cause similar pain that you should be aware of. So especially if this
is the first time you are experiencing this, don t just assume it s that. The most concerning reason
could be an infection in the joint. There is also a condition called pseudogout where a
different kind of crystal forms in the joint. Then of course there are other forms of arthritis like
rheumatoid arthritis or even osteoarthritis. So basically, if you are having symptoms, then get
into your doctor to do further testing. You will likely need to do some x-rays, get some blood
work and sometimes you made need to get some fluid taken off the joint so we can see what it is.
If you happen to be one of those unfortunate enough to get a gout attack, what can you do
to treat it? The most effective options to treat an acute attack come in the form of medication.
The most common ones that are available over the counter are anti-inflammatories like Ibuprofen
and Naproxen. Most recommend treating these by taking 800mg three times a day of ibuprofen or
500mg twice a day of naproxen. There are some prescriptions strength antiinflammatoreis like
diclofenac, indomethacin, meloxicam or celecoxib that you would need to get from your doctor.
Beyond anti-inflammatories, we can also use actual steroids which you can take either orally or
sometimes IV. A very quick and effective treatment can be a steroid injection into the joint.
These of course are all treatment options that you need to see your doctor about.
One of the best prescriptions medications that we use actually was derived from the autumn crocus
flower. It has been used for centuries to treat goutthat we call colchicine. This medicine is
meant to be taken right at the onset of symptoms. and when taken right at the onset of symptoms can
do wonders to stop the flare quickly All of these treatments seem to work better
the sooner you take it after an attack, so if you start noticing any symptoms,
get into your doctor right away. Luckily, most cases of gout can be treated
fairly easy but even better than treating gout flares is preventing them to happen
in the first place. We talked earlier about how gout occurs when our uric acid levels increase.
Uric acid comes from breakdown of purines which are mostly found in the foods that we eat. So we
find that avoiding those kinds of food can make a significant difference in preventing flares.
The foods that are most likely to cause you problems are your red meat and organs like liver.
You also need to be careful with seafood like shrimp, crab, lobster as well as more oily fish
like salmon, mackerel and anchovies. Beyond meats and seafood though are your alcoholic beverages,
especially beer as well as drinks sweetened with fruit sugar or fructose. Doing what you can to
limit these kinds of foods, should be the first step in trying to prevent a gout flare.
Gout isn t just about what you eat though. There are other things that
can increase your risk of having it. We ve found that your weight can have a big
influence. The more fat cells we have the more uric acid our body will produce. Also having
untreated conditions like high blood pressure and kidney disease also can increase your risk.
If you are taking medications and having gout symptoms, you should review with y our doctor and
pharmacist whether these can be contributing to it. Some of the most common ones are medications
used to treat blood pressure. Thiazide diuretics like Hydrochlorothiazide and Chlorthalidone,
Ace Inhibitors like Lisinpril or ramipril and Betablockers like metoprolol
can all increase your uric acid levels and increase your risk for having a flare.
Beyond diet, lifestyle and medication changes, there are some things that you
can take that can decrease the levels of uric acid in your blood and prevent a flare.
In the realm of diet, the main thing that has some effect in decreasing flares are cherries. There
is evidence that eating 10-12 cherries a day can decrease your risk of having a flare. Tart Cherry
juice is also frequently suggested as helping although the data is more limited on this.
Beyond that, there aren t a lot of supplements that have proven to have a significant effect.
There are of course medications that can help prevent further flares. The most common of which
is Allopurinol. It works by helping decrease the amount of uric acid the body produces. It s meant
to be taken daily to help prevent flares. There are two other medicines, one called probenecid
and the other is febuxostat or uloric. We ve put most of our focus on painful
joints as being the main issue with gout however there are other things that can happen as well.
We ve seen that over time, just having the levels of uric acid high, can cause a slow destruction of
the joints. So even though you aren t having a flare, you can make your arthritis worse.
You can also get deposits of crystals in the skin which form nodules that are alled
tophi that can be painful and problematic. And finally, high levels of uric acid can also collect
in the kidney and cause kidney stones. Gout can be a miserable condition but luckily
if you take it serious, make a concerted effort to change your diet, eat right, lose weight and if
those don t work take medication, it is something that you can keep from controlling your life.
Hopefully, you feel a little more informed now on how you can start to attack this condition.
That is our aim here at FamilyMed, to help you be informed so you can
make better decisions for yourself or your family. And with that, we just want to thank
you for spending a little time with us and we hope to see you in the next video.