Gout: No Longer Just for Kings
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Gout: No Longer Just for Kings

           Gout is a painful type of arthritis that commonly affects the joints of the big toe, but can also affect the ankle, heel, knees, wrists, fingers, or elbow. Like any other joint disease, gout can be painful and disabling, and yet many people with this condition sometimes fail to seek treatment due to misinformation.

            In previous eras and bygone times, gout was considered to be the disease of rich people. The prevailing thinking was that only the very wealthy or the nobility could afford the variety and quantity of rich foods, alcoholic beverages, and inactive lifestyles that were associated with the disease. What we know now though, is that while diet, alcohol consumption, and a sedentary lifestyle can all increase the risk of gout, the truth is that, like many other things, genetics play a larger part. It is because of this association with overindulgence in rich foods and alcohol, many of those who suffer from gout are prevented from seeking treatment due to this stigma.

            Gout cases are on the rise, and certainly not solely because of the fact that more people than ever can afford to eat rich food. The American College of Rheumatology reported that cases of gout worldwide have increased from the year 1900 to the present, with the number growing even today. The trend is most likely to continue as the population of the world ages. To lessen the onset of the disease and the future burden of gout, it will require better awareness, particularly of risk factors, and early diagnosis and treatment.

            Gout is caused by the buildup of excess uric acid in the bloodstream. This buildup is caused by the breakdown of substances called purines, which are found in the tissues of the body and in some of the foods that we eat. Normally, uric acid dissolves and passes through the body, but when our bodies produce too much uric acid, our bodies can’t keep up with the pace of getting rid of it. This overproduction can be caused by eating foods too high in purines, and the uric acid will form needle-like crystals that will be deposited in the joints. Our immune systems react to these crystals as a threat, which results in painful inflammation with swelling, redness, heat, and a great deal of pain.

            Recent research focuses on the genetic causes of gout. Gout runs in families, and a person with family members suffering from gout is more likely to have it. Certain enzyme defects can reduce the body’s ability to break down purines.

            Gout can be tricky to diagnose because the symptoms can be vague and mimic other diseases. Telltale signs include an attack of arthritis in only one joint, often the toe, ankle, or knee. Treatment is individualized for each patient, depending on their symptoms and the cause of their gout. The goals are to reduce pain, prevent future flare ups, and treat the underlying conditions. Gout may be treated with medications, including drugs to reduce pain and swelling, or drugs that control the level of uric acid in the body.