A patient once told me that he had “The Goutch.” I was certain he was referring to the disease called gout which was making him say “ouch!”

Gout is a very painful form of arthritis that occurs when high levels of uric acid in the blood cause crystals to form and accumulate in the joint. Uric acid is produced when the body breaks down the chemical purine. Purine occurs naturally in the body and is found in certain foods.

The great toe joint is the most common site for a gout attack. Other joints that can be affected are the ankles, knees, wrist, elbows, and fingers. The inflamed joint appears red, warm and swollen. A gout attack occurs suddenly, often at night, then eases after a few days with or without medication. Often people will say they cannot even stand the bed sheet touching the joint.

Gout can be classified as acute or chronic. Acute gout may occur only once or twice and typically will not cause tissue damage. When uric acid levels remain high over a number of years, this is now considered chronic gout. At this stage, joint damage can be seen on x-ray. Excessive uric acid crystals circulating through the body for a long period of time can cause blockage in the kidney leading to kidney failure.

X-ray of chronic gout involving the joint of the great toe and joint at base of the great toe.

We can see gout run in families due to a genetic link. But it is also associated with obesity, diabetes, high blood pressure, and high cholesterol. Gout is more common in men, post-menopausal women, and those with kidney disease.

Even though only 10% of the uric acid produced produced in the body comes from foods, a low purine diet along with life-style changes can help reduce gout attacks.

FOODS TO LIMIT IN ORDER TO AVOID A GOUT ATTACK

  • High-Fructose Corn Syrup (especially sodas and sweetened drinks)
  • Organ Meats (especially liver, kidneys, and brains)
  • Excessive Alcohol (especially beer)
  • Large Portions of Red Meat (including beef, lamb, and pork)
  • Large Portions of Seafood (especially anchovies, shellfish, sardines, and tuna)
  • Sugar, Desserts, Salt (especially sweetened cereals, bakery goods, and candy)

Fructose, a form of sugar, is getting more attention as a significant cause of gout attacks. Some consumers are not aware that high-fructose corn syrup is a main ingredient in many food products such as ketchup, barbecue sauce, and jellies.

LIFESTYLE MODIFICATIONS

  • Lose Weight if overweight
  • Stop smoking
  • Get regular exercise
  • Drink plenty of water

With the holiday season upon us, it would be nice to enjoy the festivities without a sudden attack of “The Goutch.” But if gout has you yelling “Outch!” give my office a call to get some immediate relief.