The Gout: Scourge of the Holiday Season

Thanksgiving dinner, holiday office parties, are right around the corner. Tis the season to beware of the dreaded gout! New Yorkers are more likely to eat and drink alcohol in excess during the upcoming holiday season. Next thing you know your knee, ankle, or big toe starts throbbing in the middle of the night. The bed sheets touching the top of your foot feels like a hot prod. You get out of bed and your foot is red, hot, swollen and you can't place any weight on it. Sound familiar? Gout has been well-documented throughout history as Benjamin Franklin was one of the first to lament and write about the unbearable pain. It is often referred to as the "disease of kings" but women around the menopause years may also be afflicted.

According to Dr. Allan Gibofsky, a rheumatologist and professor of medicine at Weill Cornell Medical Center in New York City , "gout is found exclusively in humans and is characterized by an elevation in uric acid, known as hyperuricemia. It is a metabolic problem resulting in either overproduction of uric acid or reduced removal of uric acid from the blood". Gout is characterized by recurrent attacks of arthritis usually occurring between the fourth and sixth decades of life and is rare to non-existent in the childhood and teenage years. Most acute attacks occur prior to age 50 in males. In the U.S. there are an estimated 2.2 million cases of patient-reported gout each year and approximately 37 million working days are lost each year to gout attacks.

"In 85 to 90% of first attacks, a single joint is usually involved with the big toe being the most commonly affected site" remarks Dr. Gibofsky. In general there is little change in their blood uric acid concentrations in females until menopause, when the concentrations increase to values found in adult men. It is primarily a disease of the legs occurring most often in the ankles, heels and knees but can also affect the wrists, fingers and elbows. "Hyperuricemia has been reported in 2 - 18 percent of the population and there is a strong correlation with body weight, height, age, blood pressure and alcohol intake" adds Gibofsky.

Hyperuricemia initially does not present with symptoms. This asymptomatic phase ends with the first attack of gouty arthritis. The first gouty attack usually occurs at least twenty years after a sustained period of hyperuricemia.

"Gout has been associated with many medical conditions. Obesity, diabetes, high blood pressure, hypothyroidism, and dehydration, just to name a few" explains Dr. Gibofsky. Medications that people commonly take can also precipitate an attack of gout. For example, low dose aspirin therapy used to address heart attack prevention and water pills such as hydrochlorothiazide have also been known to trigger a gouty attack. Environmental factors such as stress, unusual physical activity, trauma to a joint, weight loss and even a hospital stay are also recognized precipitators of a gouty attack as well as stomach disorders such as diarrhea

People who suffer from gout should watch their diet and avoid certain foods known to be rich in specific proteins known as purines. Foods such as anchovies, sardines, red meat, liver, cheese, gravies, mushrooms, lentils, shellfish, turkey, and tomatoes are known to trigger a gout attack. Any of these foods consumed with alcohol raises the risk of attack.

Treatment varies according to the individual patient. There are medications that a doctor may prescribe to control the removal of uric acid concentrations from the blood. Other medications, such as anti-inflammatories, can help the symptoms of an acute attack but are only temporary means of dealing with the painful episodes. "If you have gout, or if anyone in your family has gout you should see a physician", remarks Dr. Gibofsky". He further adds "preferably a rheumatologist who specializes in the treatment of arthritis".

For more tips on how you can prepare for the Holiday Season, click here to read more from Living!

Comments

[TheWesternBreed]

Someone I know was an occasional sufferer.

Ask the doctor for a prescription for colchicine tablets. It is based on an alkaloid derived from the Colchicum (aka autumn crocus or meadow saffron) plant, which has been used to treat gout for at least the last 1900 years. One small tablet a day, taken as soon as the first twinges are felt, clear up what were formerly crippling gout attacks for my acquaintance in a day or so, with very little pain or limping. Ask for it by name: Colchicine. Surprised no one else has mentioned it.

[Positanor]

For more information about gout go to the Hospital for Special Surgery in New York City website: www.hss.edu

[wanked]

The easiest and most effective way to treat gout is to drink as much water as possible.It always works. A gallon a day keeps the big toe away.

[DrDave]

Actually, Ben Franklin was not at all one of the first.
Gout was commented upon extensively before 2500 BC in ancient Egypt and shows up in medical works in Hippocrates and throughout the middle ages. Early treatments relied upon the the winter crocus bulb. The roman orator Seneca famously commented upon it, and Anton van Leeuwenhoek even viewed it under his microscope a generation before Franklin.

[silentlotus]

In addition this is a highly recommended
book by the Purine Research Society for gout patients.

Gout Hater's Cookbook IV

http://www.gout-haters.com/gouthaters4.html

Gout Hater's Cookbook I features comprehensive lists of highest, relatively high and lower purine foods.
Designed specifically for persons suffering from gout.

Complete with information on the latest research results, Gout Hater's Cookbook IV provides a master index of all four volumes, as well as a wide variety of vegetarian and meat dishes.
Special attention is also paid to apple cider vinegar, which assists in balancing the pH levels in the body.

[silentlotus]

If you need real help with gout, contact:
The Purine Research Society
http://www.purineresearchsociety.org/

And ask to receive their dietary recommendations.
Email:Tahma Metz{ [e-mail]}
They are extremely helpful.
My problems have been eliminated
by following their suggestions
and without taking any medication.

The more you understand about your Purine intake
the better off you will be.

[RaisingAwareness]

Your diet causes Gout. A change in your diet and time is necessary to eliminate the Gout. No amount of precription drugs is going to eliminate it and will most likely cause side-effects. Some life-threatening.



http://www.newstarget.com/022233.html

http://www.newstarget.com/019366.html

[Anastasia]

Tart cherries work for me too. I get a dried version called, Just Cherries and make a tea.

[naschkatze]

Tomatoes, huh? That was a new one for me. Thanks.

[siegfried]

I have gout. Eating a can of red tart cherries will end an attack about half way through the can. I don't know why it works. I read about it on the internet.

[tovarish]

Dr. Positano,

I am a pedorthist in a podiatric clinic where we see gout quite often.

There are a few simple things that can be done to footwear that can help alleviate the pain when ambulating.
A well fitting soft leather shoe with a full length shank and rocker bottom will limit dorsiflexion of the first hallux and can provide some relief. Perhaps even an accomodative insert with a first ray cutout can be called for

Thank you for your post.

Curtis Thompson C.Ped.

[BRUMALIA]

Excellent information!My uncle has gout and I will definitely pass this information on to him.

[Marlyn]

"It was that last Christmas pudding that did me in." Bill Clinton