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Categories > Muscles and Joints > Gout

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Finding out about gout

» How it develops

» Diagnosing and treating gout

» How serious is it?

Preventing a flare-up

These strategies can help reduce the possibility of future gout attacks:

  • Keep your weight in check. If you need to lose weight, do so slowly; rapid weight loss can actually trigger an attack.
  • If you drink alcohol, do so in moderate amounts and avoid binge drinking.
  • Drink six to eight 8-ounce glasses of water a day to prevent dehydration.
  • If you’re taking high blood pressure medication and have had a gout attack, talk to your healthcare provider. Some medications can trigger the condition.
  • Avoid purine-rich foods like sardines, anchovies, liver, sweetbreads, caviar and mussels.

Is gout a man’s disease?

For the most part, yes. In fact, a majority of people with gout are men over 40. Why? Estrogen, the same hormone that helps prevent heart disease and osteoporosis in women, also seems to protect them from gout. Still, young women can come down with gout.

It’s tough to dispel popular notions about gout. In fact, one 35-year-old woman who came down with a painful bout was shocked by the diagnosis. “Gout! That’s impossible,” she ‘told her doctor. “I’m a teetotaler and a vegetarian.” Of course, she learned firsthand that in spite of gout’s bad reputation, it can strike anyone, any time. Sometimes just banging your big toe by accident can provoke an attack.

How it develops

A painful arthritic ailment, gout occurs when uric acid builds up in the bloodstream. The body gets some uric acid from foods like anchovies, sardines and liver, which are rich in a substance called purine. But most of the uric acid in your system is produced in the body itself. When uric acid reaches high levels, it tends to form sharp crystals that lodge in the fluid around joints, typically the joint at the base of the big toe. The skin around the joint tightens, becoming swollen and inflamed.

Gout can take people by surprise. Frequently, a throbbing joint—one that seemed perfectly normal at bedtime—will awaken sufferers in the middle of the night. Fever and chills may accompany the attack, and the slightest touch of a sheet can be utter agony. Although the big toe is the joint most often affected, joints in the feet, ankles, knees, hands and wrists can also be involved.

Diagnosing and treating gout

Your doctor can confirm a diagnosis of gout by testing uric acid levels in blood or urine. Sometimes, fluid is extracted from the joint itself. To control uric acid levels, long-term medications—allopurinol if your body overproduces uric acid, probenecid if you don’t excrete enough—may be prescribed.

If you’re battling an acute attack, your best defense may be nonsteroidal anti-inflammatory drugs. (But steer clear of aspirin, which can increase the amount of uric acid in your blood.) Indomethacin or colchicine, a drug with a centuries-old history of easing gout pain, also may be prescribed.

How serious is it?

Left untreated, a gout attack usually disappears after several days. But without medical care, gout is likely to recur, with flare-ups becoming more frequent, lasting longer and affecting more joints. Eventually, joint problems, kidney disorders or kidney stones can arise. The bottom line: Proper treatment keeps gout-related problems—not to mention the pain—at bay.

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