Gout

If you wake up in the middle of the night with excruciating pain in your big toe, you could have gout. Or perhaps your instep, heel, ankle, or knee hurts. How about your wrists and elbows? Your joints can become so inflamed that even rubbing against the bed sheet can be torture. You may even experience fever and chills.

Gout is a form of arthritis. It is caused by increased blood levels of uric acid, produced by the breakdown of protein in the body. When blood levels of uric acid rise above a certain level, thousands of hard, tiny uric acid crystals collect in the joints. These crystals act like tiny, hot, jagged shards of glass, resulting in pain and inflammation. Crystals can collect in the tendons and cartilage, in the kidneys (as kidney stones), and in the fatty tissues beneath the skin.

Gout usually happens in one joint at a time. In addition to intense pain, you may have swelling, redness, and warmth in that joint.

A gout attack can last several hours to a few days.

A gout attack can be triggered by:

• Mild trauma or blow to the joint
• Drinking alcohol (beer and wine more so than liquor)
• Eating a diet rich in red meat (especially organ meats such as liver, kidney, or tongue). Also, foods and beverages high in fructose.
• Eating sardines or anchovies
• Taking certain drugs, such as diuretics

Don’t assume you have gout without consulting a physician. Many conditions can mimic an acute attack of gout (including infection, injury, or rheumatoid arthritis). A doctor can accurately diagnose your problem.

Treatment

Treatment will depend on why your uric acid levels are high. Your doctor can conduct a simple test to determine whether your kidneys aren’t clearing uric acid from the blood the way they should, or whether your body simply produces too much uric acid.

• For immediate relief, your doctor may prescribe colchicine or a nonsteroidal anti-inflammatory drug and tell you to rest the affected joint.
• For long-term relief, your doctor will probably recommend that you lose excess weight, limit your intake of alcohol and red meat, drink lots of liquids, and take medication (if necessary)