Gout is a form of arthritis, frequently seen in middle aged men. The classic presentation of gout is a red, hot, swollen joint at the base of the big toe which comes on suddenly without warning. Gout is a disease caused by uric acid, a substance produced normally by our body, but individuals with gout have an excessive amount of uric acid in their bloodstream. The uric acid forms crystals in the blood which have a tendency to pool in the cooler areas of the body. When a large quantity of these crystals are present in a joint, an intense inflammatory reaction occurs, leading to severe pain and swelling.

Gout is most commonly seen in the big toe joint, however any joint can be affected. For most patients with an attack of gout, the redness, swelling and pain will resolve with treatment within 1 to 2 weeks. The painful attacks of gout can unfortunately become a recurrent condition with repeated attacks leading to joint destruction and chronic pain.

The elevation in uric acid levels associated with gout can be caused by multiple factors. A diet high in rich foods, most notably alcohol, red meat and shellfish, can predispose a patient to gout. Patients with kidney problems and those with a family history of gout, are at greater risk for developing the condition. The medications a patient takes, particularly water pills and aspirin, may be associated with increased uric acid levels.

The initial treatment for a gout attack is aimed at reducing pain and swelling. This may include rest, elevation, injections and anti-inflammatory pills. To avoid recurrent flares of gout pain, preventative maintenance may include weight loss, diet modification and hydrating well, preferably with water. Patients suffering from repetitive flares of gout may require a daily medicine to lower the uric acid level in the bloodstream in order to prevent further joint destruction and pain.


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