Gout: it’s no longer just a king’s disease

In the middle ages, kings and other royalty were most often afflicted with gout because they were the only ones that could afford diets rich in meats and alcohol which led to obesity.  Now we all eat like royalty, so gout is more common in the general population. For about 10% of people, diet is a major contributor to gout.  Foods such as organ meats, red meats, shellfish like shrimp, beer and wine are high in purines that get converted to uric acid in our bodies.  Cutting back on those foods can help.  Limiting sugary drinks may help as well.

People that are obese, have high blood pressure, and high cholesterol (called metabolic syndrome) are at increased risk of gout.  Weight loss will help.  There can be a genetic predisposition for gout as well.

So, what does gout look like?  It often presents as severe pain, swelling, redness, and inflammation in a joint which starts in the middle of the night.  Most commonly (50% of the time) it attacks the joint at the base of the big toe, but can occur in most any joint, or even along the Achilles tendon or plantar fascia.  Often the weight of bed sheets on the area may become intolerable.

There are other conditions that can mimic gout such as infection in a joint, psoriatic arthritis, etc…  Your podiatrist can help determine if you have gout and the best course of treatment.  It may require x-rays, blood testing, or withdrawing some fluid from the joint to look for gout crystals.  Several treatment options are available to help reduce the pain of a gout attack and speed up the healing.  If gout attacks become repeated, then a medicine called allopurinol may be needed to reduce the uric acid level in the bloodstream.  If gout persists over long periods of time it can cause permanent damage to joints and even the kidneys.