Gout (Gouty arthritis)

GoutUric acid is one of the body’s waste products. Usually it is eliminated by the kidneys. In some circumstances, however, it accumulates in the blood and forms crystals. These crystals are then deposited in certain joints (e.g., the elbow, knee, fingers), causing extreme pain and swelling. The feet (especially the big toes), knees, and finger joints are most at risk. Gout attacks often occur in the early morning. They are unpredictable: they can occur a few days or months apart, and last anywhere from a few hours to a few weeks.

Where does gout come from?

Gout is a hereditary disease that is much more frequent in men than in women. It rarely occurs before the age of 40 and is found in all socioeconomic classes. An impressive number of celebrities have suffered from this disease, including Alexander the Great, Isaac Newton, Benjamin Franklin, and Martin Luther King.

What can you do to prevent gout?

Certain foods are known to precipitate gout attacks. Avoiding these will help. But sometimes a special diet is not enough. In that case, your doctor will prescribe drugs that are designed to reduce blood uric acid levels: either drugs that increase blood uric acid elimination (uricosurics) or a drug that decreases the formation of uric acid (allopurinol).

How can you treat a gout attack?

Colchicine or anti-inflammatory drugs are used to stop an attack. Colchicine acts more quickly but, because it induces diarrhea, it is no longer used as a front-line agent. Instead, anti-inflammatory drugs are preferred. They are effective and, when taken with food or milk, cause few side effects.

What can happen if gout is not treated?

Gout can eventually cause joint deformity. The crystals form whitish deposits, called tophi, in certain tissues. Sometimes gout causes the formation of kidney stones. Gout: Dietary Recommendations Acute, intense joint pain, often occurring in the great toe or a finger, may be the first manifestation of a gout attack. The pain is usually associated with redness, local swelling, and warmth. Food containing purines, which the body transforms into uric acid, can cause gout. So if you have gout, avoid purine-rich foods, such as:
  • anchovies, herring, sardines, and mackerel
  • innards: heart, liver, kidneys, brain, and sweetbreads
  • shrimp and scallops
  • venison
  • gravies and beef bouillon substitutes (Oxo, Bovril, etc.)
And eat the following purine-rich food only in moderation. Do not eliminate these foods from your diet:
  • crab, lobster, and oysters
  • vegetables: asparagus, mushrooms, cauliflower, spinach and peas
  • legumes: beans and lentils
  • freshwater and saltwater fish
  • soups made with meat stock
  • cereals: whole-grains, oat flour, wheat germ, bran germ
  • meat and poultry
Since uric acid crystals can also accumulate in the kidneys, drink lots of fluids to prevent the formation of kidney stones. Limit alcohol consumption. Always watch your diet: it has a strong impact on your health!

For more information or for support

The Arthritis Society www.arthritis.ca