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Gout

Gout is a common type of arthritis (inflammation of the joints) caused by having an unusually high level of uric acid in the body. Uric acid is a normal product of metabolism. It is made in the liver and then enters the bloodstream. Most of it passes through the kidneys and the body excretes it in the urine. The remainder is broken down in the intestines. Usually, these processes keep the blood concentration in a normal range. However, in some instances the balance is shifted due to the body producing too much or not eliminating enough.

The normal level of uric acid in the blood is less than 6.8 mg/dl. When the level reaches 7 mg/dl or higher tiny crystals of uric acid can form and deposit in the joint tissues, causing pain and inflammation. In many cases, the ultimate reason for this imbalance is not well understood. However, some things do increase the likelihood of developing gout, such as alcohol ingestion or certain medications, such as a class of drugs called Thiazide diuretics which are commonly used to treat high blood pressure. However, it is important to note that Thiazide diuretics are a very important part of our arsenal for treating high blood pressure and most people who take this medication never develop gout.

For some people, even low dose aspirin precipitates attacks of gout, as does niacin supplementation. As with Thiazide diuretics, the percentage of patients treated with low-dose aspirin and niacin who actually develop gout is low. If your physician recommended these medications, especially for heart disease or prevention thereof, do not stop taking them without first consulting with your physician. Also, do not try to diagnose yourself with gout. Many people have pain in the big toe (and other joints) completely unrelated to gout.

Some diseases are also associated with an increased incidence of gout. It is also interesting to note that something as common as psoriasis may increase your chance of developing symptoms of gout at some time.

A classic case of acute gout is pain, redness, and swelling of the large joint of the big toe (between the foot and toe itself). This can be extremely painful. As a matter of fact, you may not be able to walk during an episode of acute gout. However, the severity of the pain can vary significantly.

Gout is generally easy to treat. If you develop pain in a joint (or other bothersome symptoms for that matter) see your doctor and let her diagnose your problem and prescribe appropriate therapy.

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