Gout

Gout is caused by an elevation of uric acid within your blood.  Uric acid is a natural substance in your body that is a breakdown product of proteins.  Gout occurs in people who either make too much uric acid, eat too many foods that are high in uric acid, or in people who cannot get rid of excess uric acid in their blood.  Gout medicines focus on helping your body produce less uric acid, or helping your body eliminate excess uric acid.

Where does Uric Acid come from?

You naturally produce most of the uric acid in your body, but there is a percentage (up to 20%) of uric acid that comes into your body through diet.  Adjusting your diet by avoiding foods high in uric acid can help reduce your chances of repeat gout attacks.  In addition, keeping yourself very well hydrated with water is helpful.  Some medications can make a gout attack more likely, including some blood-pressure pills (water pills).  Your doctor may adjust these medications if gout becomes a problem.

In addition to medicine, you can help avoid future gout attacks by following the following diet guidelines:

Eliminate the following:

Liver    Kidney     Anchovies      Sweetbreads   Sardines      Brains     Heavy gravies      Heart    Fish roes    Mussels     Herring    Beer / Wine    Meat extracts, consommé

Reduce the following foods to no more than one serving per day:

Meats     Beans   Fowl     Peas   Cauliflower   Mushrooms Other seafood   Lentils     Spinach Yeast      Asparagus    Whole grain cereals    Fish (except noted above)

These foods do not cause gout:

Fruits     Milk       Cheese    Eggs     Refined cereals   Nuts   Spices (including salt)   Sugars & Sweets    Vegetable soups (clear)    Vegetables

Diagnosis & Treatment

A blood test may be used to test the uric acid level.  It is common; however, that the blood level of uric acid may be normal even while a person is having a gout attack.  If the diagnosis is in question, a sample of joint fluid may be taken and tested for gout crystals.  Most cases of gout affect the big toe joint but other areas can also be affected.  The pain can be quite severe and result in joint swelling and redness.  Walking may be difficult and pressure of a shoe or even bed covers can be painful.  Treatment for the acute, severe pain may include anti–inflammatory medications (such as indomethacin or colchicine) or injections near the area.  A sandal or surgical shoe may be useful to relieve pain as well.