We don’t often find ourselves chuckling at infections, heart disease, or other illnesses that can affect us. But gout? This excruciating condition has been at the center of jokes of cartoonists and comedians for centuries. The reason why gout is sometimes depicted as humorous lies in its causes. It is known to be a disease of men who can afford a rich, lavish lifestyle. Because it is characterized as the disease of over-indulgences, those suffering have been the targets of mockery for many years.

Gout is caused by over production of uric acid, which is normally found in our bodies only in small amounts. Our bodies break down protein though metabolism and the end result is uric acid. More uric acid is made in our body by overconsumption of alcohol, fatty foods, meats, and protein rich foods, like caviar! Please note that not all sufferers of gout are over-indulgers as sometimes this disease is caused by problems with protein metabolism or problems in the kidneys. Either way, if the uric acid becomes too concentrated in the blood stream, small crystals will form. These crystals will deposit into tissues of our bodies like our kidneys and joints. The joint of the big toe is most often affected. Uric acid crystals mount an attack on the joints and can eventually cause joint breakdown and severe arthritis. In the acute stage, the joint will appear bright red, swollen, and excruciatingly painful to move or touch. Spoken from a gout sufferer as the bed sheets moved over the foot, “I felt like my big toe was about to explode!”

Patients usually seek podiatric treatment during an acute flare up but this is the same as being at the bottom of a waterfall. Treatments for gout include rest, ice, injections, NSAIDS (medications similar to Ibuprofen), compressive dressings, and oral medications. Sometimes even surgery is performed to remove tophi, which are large deposits of uric acid crystals. Most importantly, medical management by primary care physicians or rheumatologists should be directed at treatments to keep uric acid levels down. Back to our waterfall analogy, medical management keeps boats and rafters away from waterfalls.

But what can we do to prevent the gout flare ups? Number one, avoid alcohol. However, if you do enjoy an “adult beverage,” keep them limited to 1-2 per hour. Get plenty of water and stay hydrated! Also, it certainly helps to exercise and get moving!

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