Gout: Dr. Rosemary Leonard advises on symptoms and treatment
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“Gout is a type of arthritis, causing severe, sudden attacks of inflammation in a joint,” Dr Fields explains. “Your joint may be visibly swollen and even feel warm when you touch it.” One of the “gout’s favourite target” is the joint in the big toe, but it could also appear in the ankle, knee, elbow, hand or wrist.
The “sudden” gout attack will cays “severe pain and swelling in the joint”, which may swell and turn red.
“You may wonder if it’s infected or even fractured. But it’s not – that’s the inflammation,” said Dr Fields.
He added: “There is a misconception that gout is caused by eating rich, fatty foods, but this is not true.”
Rather, there is a genetic component, Dr Fields clarified, adding that “certain foods can set off a flare”.
Dr Field clarified that specific foods rich in purines are better left off the dinner menu if you have a genetic predisposition for gout.
These foods include:
- Organ meats, such as liver and kidney
- Red meat, such as beef and pork
- Shellfish, such as mussels, scallops, and oysters
Moreover, gout attacks could be triggered by “all forms of alcohol”, as it “increases urate in the body”.
Dr Fields stated: “Gout is caused when an excessive amount of urate (also called uric acid) builds up in your blood and crystallises around a joint.
“Urate is produced by your own body as it metabolises, or breaks down, purine, a substance made naturally by the body.”
Dr Fields said: “About 90 percent of people with gout reabsorb too much urate in their kidneys because of genetic factors.”
People who have decreased kidney function, due to high blood pressure or diabetes, for example, might also be more prone to high urate levels in the blood.
Risk factors for gout includes:
- Diuretic medications
- Insulin resistance
- Congestive heart failure
- Metabolic syndrome
- Kidney disease.
“If you notice signs of gout, see your doctor right away to get an accurate diagnosis and start treatment,” Dr Fields advised.
“A good place to start is your general practitioner, who may then refer you to a rheumatologist, who is an arthritis specialist.”
Expect to discuss your diet and drinking habits, current medical conditions, and a blood test to measure uric acid levels.
Further investigation might require X-rays on the affected joint to highlight any areas of damage.
“When appropriate, fluid can be removed from a joint and the fluid examined for crystals of urate,” Dr Fields added.
Once diagnosed, treatment can vary from ibuprofen to oral steroids and a prescription anti-inflammatory medication, such as oral colchicine.
People who don’t have a genetic tendency to develop gout are “unlikely” to experience the condition – “no matter what your diet is”.
Theodore Fields, M.D., F.A.C.P., Attending Rheumatologist, Hospital For Special Surgery, Professor of Clinical Medicine at Weill College of Medicine of Cornell University and medical advisor to CreakyJoints.
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