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Life in Motion

The Truth About Gout

Joint Health

Gout is a form of inflammatory arthritis that causes sudden, severe joint pain, swelling, and tenderness. Gout most commonly affects the large joint of the big toe, but did you know that it can affect any joint? Gerald Miley, MD, rheumatologist at NEBH, explains the causes, evaluation and treatment options for this painful disease.

Common Causes of Gout

Gout is caused by an accumulation of uric acid crystals in the joints, which leads to inflammation. These crystals can also deposit in the kidneys and cause kidney stones or in the skin to cause bumps called tophi. This can occur if your body cannot excrete uric acid, or if your body makes too much uric acid.

Certain foods and drinks increase the risk for gout. These include shellfish, red and organ meats, beer, liquor, and fructose containing sodas. Dairy products and cherries can help to decrease the risk for a gout episode.

Evaluation and Treatment Options

Testing your blood for uric acid is very important. If you or your doctor suspect gout the test must be ordered separately as it is not part of routine chemistry panels. Also, many patients have a normal uric acid when they are having an acute attack which might falsely lead your doctor to think gout is not the correct diagnosis. Repeating the test after the acute episode has passed can help make the correct diagnosis.

When left untreated gout can be debilitating. If your gout is not flaring, it is important to exercise regularly and eat a balanced diet to keep your body and joints healthy. During a flare, the following steps can be taken:

• Rest and elevate the affected joint for 24 hours after the initial attack.
• Apply ice/cold packs for up to 30 minutes, several times a day.
• Avoid taking high doses of aspirin, which can alter your uric acid levels.
• Avoid alcohol, red and organ meat, shellfish and foods high in sugar.

Talk to your doctor about medications including anti-inflammatory drugs, colchicine, allopurinol and febuxostat, which are used long-term to lower uric acid levels and to help prevent recurrent attacks and joint damage.

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