What is gout?

“Gouch!” That’s what people called it where I grew up in the hills of eastern Kentucky. Gout is one of the most painful forms of arthritis. It used to be called the “disease of kings and the king of diseases” and has afflicted peoples since ancient times. It used to be one of the most common debilitating diseases, but modern medicine has largely controlled it. Unfortunately some people still suffer the pain of gout despite medications.

Gout is caused by a buildup of the chemical called uric acid in the body. Elevated uric acid can deposit in the joints (usually the big toe), causing arthritis. Uric acid can also build up in the kidney resulting in kidney stones, or even under the skin, causing lumps under the skin.

An attack of gout may occur during sleep, and the first attack is often in the big toe. It results in redness, pain, swelling, warmth and stiffness of the joint. An attack can be brought on by stress or by alcohol. Attacks usually get better within three to 10 days, even without medical treatment. The next attack may take months or even years to strike.

If gout is caused by elevated uric acid in the blood, where does uric acid come from? Uric acid is a breakdown product of another one of the chemicals that occurs naturally in your body—purine. Normally, the uric acid just passes out of the body through the kidneys, but a buildup of uric acid can occur if too much uric acid is being produced by the body, if the kidney cannot get rid of the uric acid that is normally being produced, or if you are eating foods that are high in purines (meat, seafood, certain kinds of beans).

Just because the uric acid is high doesn’t mean that gout will occur. When the uric acid forms crystals, and the crystals deposit in the joints, causing an attack of arthritis, then you have “gouch.”

According the National Institutes of Health, you are more likely to have gout if you:

Have family members with the disease
Are a man
Are overweight
Drink too much alcohol
Eat too many foods rich in purines, such as meat, seafood, and certain kinds of beans.

An attack of gout is treated with pain medications, anti-inflammatory medications, and a drug called colchicines, which decreases the amount of uric acid the body. Some doctors will use colchicines to prevent further attacks.

If you have had gout, there are a few things you can do to help prevent further attacks: take your recommended medications, drink plenty of water to help wash out the extra uric acid, avoid alcohol, avoid foods that contain lots of purines, exercise regularly and get to a healthy weight.

(David Khorram, MD is a board certified ophthalmologist, and director of Marianas Eye Institute. Questions and comments are welcome. Call 235-9090 or email eye@vzpacifica.net. Copyright © 2005 David Khorram.)