Dr. Simon Raskin, AACFAS, FCCWS


Gout is a kind ofarthritis caused by too much uric acid in the joints. Uric acid is a substance that forms when your body breaks down a substance called purines. This substance normally dissolves in your blood and passes through your kidneys into your urine. In people with gout, uric acid builds up and forms sharp crystals that can collect around the joints. This causes pain and swelling in the affected joints.

Who can get gout?

If you eat a lot of foods that are rich in purines, you may get gout. Some of these foods are salmon, sardines, liver and herring. You may get gout if you're overweight, drink alcohol or have high cholesterol. Men have gout more often than women do. Women are more likely to have gout after menopause. Medicines that may cause gout include the following:

certain diuretics ("water pills") niacin (a B-complex vitamin) aspirin (taken in low doses)
cyclosporine (brand names: Sandimmune, Neoral, SangCya) some drugs used to treat cancer.

What is a gout attack like?
It maybe sudden. It usuaUy starts at night, often in the big toe joint. The affected j'oint becomes red; feels hot and hurts: The joint hurts more when you touch it. Other joints may also be affected.

What should I do ifI have a gout attack?

You should rest in bed. Putting a hot pad or an ice pack on the joint may ease the pain. Keeping the weight of clothes or bedding off the joint can also help; Medicines that you can take without a prescription that reduce inflammation, such as aspirin or ibuprofen (one brand name: Motrin),
may help.

Your doctor can also prescribe medicine for you.

The sooner you get treatment, the sooner the pain will go away. Your doctor can prescribe medicine to stop the joint swelling and pain. With treatment, your gout attack should go away in a few days.

What if I don't get treatment?
If you don't get treatment, a gout attack can last for days or even weeks.
If you keep having more attacks, more joints will be affected, and the attacks will last longer.
If you have gout attacks for many years, you may develop tophi (say "toe-fee"). These are soft tissue swellings caused by uric acid crystals. Tophi usually form on the toes, fingers, hands and elbows. You may also get kidney disease or kidney stones. Over time, the bone around a joint may be destroyed by gout.


What can I do to avoid gout attacks?

Your doctor can prescribe medicines to prevent future gout attacks. These medicines can wash the uric acid from your joints, reduce swelling and keep uric acid from forming. Lose weight if you are overweight. If you have high blood pressure or high cholesterol, get treatment and follow a low-salt, low-fat diet. Stay away from alcohol and foods that are high in purines. Drink lots of water. It can help flush uric acid from your body.

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