Gout: Symptoms, Causes and Treatments
Gout is the most understood and usually one of the easiest of the rheumatic diseases to manage. Gout is a form of rheumatoid arthritis and it usually occurs at the base of the big toe, right where the toe meets the foot. This can be on the side of that area or on top. It can have the following symptoms, which can happen rather quickly.
- Sometimes very painful to walk and to touch.
- Red around that area.
- It can feel hot to the touch.
The big toe area is where this usually occurs, it can also occur in the ankle, instep, heel, knees, wrist, fingers and the elbow. The pain can get bad enough that you can’t even let the toe touch anything, not even the bed sheets. Many times this pain will go away without any action on your part.
What is Gout and what causes it
Gout occurs when urate crystals form and accumulate around the joints. Urate crystals can form when you have a high rate of uric acid in your body. Uric acid is a chemical that is created when the body breaks down substances called purines. Purines are a type of protein found in many foods. When your body produces too much uric acid or your body doesn’t eliminate enough uric acid, it can accumulate, forming sharp needle-like urate crystals around the joints and in tissues, which cause the pain and inflammation. Purines come from certain foods and drinks such as beer, wine, red meat, anchovies, mackerel and liver. Basically foods that are high in saturated fat and cholesterol are high in purines. It used to be said that gout was the rich mans disease or the disease of kings because of the rich foods that causes gout and only rich people could afford those foods.
List of high purine foods
- Red meat, all chicken or red meat organ foods such as liver or kidneys.
- Certain fish such as sardines, mackerel, scallops, mussels and herring.
- Fish eggs
- Broth, bouillon, gravy and consommé
- Yeast in supplement form
There are conflicting studies about high fat dairy products, some studies have said they are a food that can cause gout and other studies actually say that dairy foods were associated with reduced risk. As the uric acid moves through the body, most of it is dissolved in the blood, then into the kidneys and out through the urine. If too much uric acid continues to flow through the kidneys, it could also cause kidney stones.
Foods aren’t the only cause of high uric acid levels in the body. Poor kidney function can cause a buildup of uric acid (called hyperuricemia). Other causes for gout are certain medications such as a diuretic, family history of gout, excessive use of alcohol, low-dose aspirin regimen and the use of anti-rejection drugs after an organ transplant.
Helping the pain
Usually an attack of gout will hit you in the foot, the big toe area, this is by far the most common. There are some things you can do for yourself when you get these symptoms of gout.
- You should try and stay off of your feet for a day and elevate your foot above chest level.
- Put ice on the affected area, not heat.
- Drink a lot of water, flush your body and kidneys out and keep drinking water.
- Don’t drink alcohol.
Keeping episodes of gout away.
If you have these periodic episodes of gout, try and keep a food diary to see if you can find the foods that cause you to get this. When you get these symptoms, do they seem to happen after a period of high alcohol use or eating the foods that are high in purines.
Drink a lot of water to flush your body and kidneys. Avoid the foods that are high in purines. And reduce or stop all alcohol.
Drinking plenty of water and certain foods can aid the kidneys in eliminating the uric acids. These foods are tofu, olive oil and nuts, which seem to counteract weakened kidney function. A more moderate diet with less of the high fat, high cholesterol foods and alcohol could prevent a recurrence of gout. A vegetarian diet could also help you if you continue to get these symptoms. People with gout should not follow any of the high protein low carbohydrate diets. Losing weight can also help reduce the risk of gout, since being overweight causes the body to produce more uric acid.
It has been my experience that whenever I get the swelling and pain in the big toe area, it always seems to follow too much alcohol accompanied with high purine foods such as red meat. Even though I didn’t see this listed in any reference, coffee seems to cause pain and some swelling in the toe area. That could be because coffee and caffeine are diuretics.
See a doctor:
- If these symptoms spread to other areas and other joints.
- If there is a fever along with the pain and redness and hot to the touch, that could be an infection and for that you would need to see a doctor right away.
- Gout that goes untreated can lead to worsening pain and damage to the joint.
© 2009 Sam Montana
American College of Rheumatology
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Also see the article: Natural treatments for rheumatoid arthritis