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What is Gout? The Disease of Kings

Gout is an old disease — really old. In fact, the ancient Egyptians first identified this condition more than 4,600 years ago. In the 5th century B.C.E, the Greek physician Hippocrates dubbed gout as the “arthritis of the rich” after noticing the disease’s relation to the wealthy’s overindulgent diets of alcohol and rich foods. For years, gout was thought of as only a “rich man’s disease.” The condition acquired quite the reputation — not because of the extreme pain and discomfort it caused — but as a revered status symbol of wealth and class.

Today, however, we now know that anyone can get gout regardless of diet. In fact, gout is considered one of the most well-understood and described types of arthritis today. Unfortunately, it also happens to be one of the most painful types of arthritis.

While modern medicine has yet to find a cure for gout, it is an easily treatable condition. Many gout patients successfully find remission with the combination of medicine and lifestyle changes we will discuss in this article.

What Causes Gout?

Gout is caused by hyperuricemia, a condition that occurs when too much uric acid collects in your blood. Uric acid is a byproduct of purine, one of the building blocks of DNA. Everyone’s body contains trace amounts of uric acid, and most, if not all of it, is dissolved in our blood and eventually excreted through our urine (hence the name “uric” acid).

However, our blood can only dissolve so much of it. When uric acid can no longer be dissolved into your bloodstream or excreted by your body, it begins to crystallize in your joints. This is where the onset of gout begins.

The pain and inflammation from gout is actually your body’s immune system responding to the crystal formation. White blood cells begin to clear the crystals, and by doing so, they cause the area to become tender, red and swollen.

Where Does Gout Impact the Body?

Gout most commonly affects the base joint of the big toe, but the urate crystals can form in several other joints, including the:

  • Knees
  • Ankles
  • Elbows
  • Wrists

Risk Factors

Both genetic and environmental factors may contribute to the development of gout. These include:

  • Genetics. Many gout patients are genetically predisposed to have higher levels of uric acid in the body.
  • Obesity. People who are obese have a higher risk of developing gout.
  • Diabetes. People who have diabetes are at a higher risk of developing gout.
  • Alcohol. People who drink excessive amounts of alcohol are at an increased risk of accumulating higher levels of uric acid in the bloodstream.
  • Diet. Certain foods are naturally high in purine, including shellfish, fatty fish, red meat, and organ meat (i.e. liver).
  • Sugary drinks and snacks that contain high fructose corn syrup may also contribute to purine production.
  • Dehydration. Being dehydrated can increase the concentration of uric acid in the body.
  • Chronic Kidney Disease. People with chronic kidney disease have a higher risk of developing gout.
  • Certain Medicines. Some medications, mainly diuretics, can increase the risk of gout.
  • Chemotherapy. Chemotherapy and radiation treatments can also increase uric acid levels in the blood.

What Does Gout Feel Like?

The main symptoms of gout are severe pain, redness, and inflammation — most likely at the base of your big toe. It most often occurs while asleep or early in the morning, and many report being woken up by the pain, as if their toe’s on fire.

Thankfully, gout is limited to short outbursts called gouty attacks or flares, with the severe pain typically lasting for only a few hours. However, low to moderate symptoms may continue for days or weeks. If you were to experience repeated gout attacks, doctors would then consider it chronic gout, which can actually destroy the joint if left untreated.

Hard, permanent crystals called tophi may also form, which closely resemble the bony growths commonly seen in hand osteoarthritis. Gout patients may also develop these urate crystals in their bladder as kidney stones.

Gout is a Treatable Condition

Humans have known about gout for thousands of years, so we’ve had lots of time to learn how to treat it. Even today, modern medicine still uses colchicine to treat gout. It’s an ancient anti-inflammatory medicine derived from the dried seeds of the autumn crocus flower.

Other methods your doctor may recommend to treat acute gout include:

  • Allopurinol, which is a xanthine oxidase inhibitor limits the amount of uric acid produced by the body.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil) and naproxen (Aleve). Aspirin is not recommended as it can inhibit the excretion of uric acid.
  • Corticosteroid injections can also provide relief to the inflammation caused by an acute gout attack.

You Can Treat the Underlying Cause of Gout

The majority of gouty attacks are preventable. Through a combination of medication and lifestyle changes, you can help reduce the uric acid levels in your blood.

Your doctor’s treatment plan may include:

  • Prescription medication, such as allopurinol or febuxostat, to lower the concentration of uric acid
  • Avoiding foods rich in purine, such as red meat or shellfish
  • Avoiding alcohol
  • Drinking more water
  • Losing weight

If you suspect you have gout, it’s best to address it as soon as possible. We always recommend contacting your healthcare provider or your arthritis relief specialist if you have questions regarding gout or other types of arthritis.

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