Ten Facts about Gout

In the past, people had little understanding of gout. The term “gout” is originally derived from the Latin “gutta” which literally translates to “drop.”  It was thought to originate from a “drop” of bad humor in an inflamed joint back in the 13^th century. Today, unlike the past, we know what causes gout attacks and have very effective treatment options. 

1. Gout occurs when excess uric acid, a byproduct of purine breakdown, collects in the body. Purine is a compound found in many common foods.
2. During a flare of gout, patients experience pain, warmth, swelling, and redness with skin hypersensitivity around a joint.
3. Up to 50% of cases of gout occur in the first metatarsalphalageal joint, where the big toe connects to the foot, but flares of gout can occur in just about any joint. 
4. Advanced age, obesity, and alcohol consumption are three prominent risk factors for the development of gout.
5. Gout usually occurs in three phases.  The first is characterized by sudden pain and swelling, which usually resolves in 7 – 10 days.  This is followed by a short or long period of dormancy, then recurrent sudden attacks of gout. 
6. Some patients could see an improvement in flare symptoms when identifying foot “triggers.”  Foods high in purine content, including shellfish and red meats, organ meats, sardines and anchovies, alcohols (particularly beer and wine), sugary drinks and foods that are high in fructose are main culprits.  However, avoiding these foods alone may not change the uric acid level enough to make a difference.
7. It’s best to see your primary care provider if you suspect a case of gout, who may order a blood test and may recommend an anti-inflammatory regimen or other medication to help.  
8. Certain medications such as diuretics may complicate this disease.
9. In serious cases, your providers may also recommend you see a rheumatologist for more advanced treatment.
10. If left untreated, patients sometimes experience permanent or persistent swelling, mild-to-moderate joint pain and stiffness, and presence of gouty deposits called “tophi.”   Destructive arthritis can be directly correlated to recurrent flares and delayed treatment.

Gout can be somewhat complex to treat, but it is worth the time and effort. Treating it successfully will sidestep painful long-term consequences.

Matthew Stanishewski, DO, is a rheumatologist at SVMC Rheumatology. The practice is part of Southwestern Vermont Medical Center in Bennington.