Everything you need to know about gout

Gout can be a terribly painful disease that affects many Canadians. Here's everything you need to know about gout, including some simple ways to reduce your risk.

Marked by swelling, inflammation and excruciating tenderness in the joints, gout most commonly affects the joints at the base of the big toe, other foot joints, knees, ankles, wrists and fingers. The slightest touch — even that of a bed sheet — may prove to be unbearably painful during an attack of gout.

• In North America, gout afflicts about 21 out of every 1,000 people, about half of whom are overweight. It is uncommon in women, especially before menopause.
• Mistakenly, gout has had a persistent reputation for being the penalty to be paid for high living and overindulgence. In fact, gout is actually a type of arthritis caused by an inherited defect in the kidney's ability to excrete uric acid. This waste product of protein metabolism comes both from the digestive process and from the normal turnover of cells.
• When deposits of uric acid crystals build up in the synovial fluid that surrounds the joints, the human body's immune system attempts to eliminate these crystals through the process of inflammation; unfortunately, this causes attacks of intense pain that can continue for days or even weeks if the condition is left untreated.
• Over time uric acid crystals accumulate in the form of lumpy deposits under the skin of the ears, the elbows and near the affected joints.

Gout attacks usually occur suddenly and unpredictably. The good news is that there are now several drugs available that will stop the pain and prevent any future attacks.

• Col­chi­cine, a drug derived from the autumn crocus flower, is one of the fastest acting and most effective of these. Unfortunately, it can also cause severe nausea and diarrhea, which necessitate stopping the drug immediately. Before these side effects develop, however, the gout attack has usually abated, and the gout ­sufferer no longer needs to continue taking the medication.
• Other, less toxic, drugs are given on a long-term basis to prevent the onset of attacks; a flare-up is likely if these drugs are stopped, however. To reinforce the beneficial effect of drug treatment, people with gout should make die­tary changes to help reduce their production of uric acid.

Consume plenty of:

• Fluids to dilute the urine and prevent the formation of kidney stones.
• Fresh fruits and vegetables (except those high in purines) for vitamins, minerals and dietary fibre.

Limit:

• Vegetables high in purines, such as cauliflower, asparagus, green peas, spinach and mushrooms.

Avoid:

• Organ meats, game, anchovies, sardines, herring, meat extracts and other high-purine foods.
• Alcohol, especially red wine and beer.
• Diuretics and aspirin-based drugs.
• Skipping meals or crash diets.

Keep these tips in mind and remember to contact your doctor for more information on reducing your risk and controlling gout.