Gout
Gout, or a gouty attack, is
caused by an increase in the amount of uric acid crystals in the body.
Symptoms
Redness, swelling and intense
pain characterize what most people experience during an acute gouty
attack. Often the light touch of bedsheets can elicit pain.
In the foot, pain and swelling usually occurs in the great toe joint;
which is the furthest joint (coolest) from the heart, or the body’s
core heat.
Causes
Many foods contain high levels
of purines of which uric acid is a byproduct. These foods would include
red meat, shell fish, red wine and alcoholic beverages as a group.
Two other inherited causes for a gouty attack include (1) the body’s
overproduction of uric acid crystals and (2) the body’s inability
to excrete normal amounts of uric acid crystals. Medication, such
as high blood pressure medication (water pills), can lead to a build-up
of uric acid crystals.
In the past gout has been referred
to as "the rich man''s disease". This is because during the
middle ages only the wealthy people were able to afford to eat these
''rich'' foods. Consuming foods and alcoholic beverages that may contain
high levels of purines may contribute to an attack of gout.
Diagnosis
Your Podiatric Physician can
usually make this diagnosis after a thorough history and physical.
In certain cases x-rays and blood tests are often ordered to confirm
the increase in uric acid and to determine whether or not there is another
cause of the inflammation.
Treatment
Treatment typically begins
with prescription oral anti-inflammatory medication. This, together
with a change your diet, can reduce the symptoms of a gouty attack.
However, significant reduction in the amount of gout producing foods
including shellfish, red wine, red meat, etc. is necessary. Severe
acute attacks may require oral steroids or a steroid injection to the
affected joint to allow for immediate relief. If you experience
repeated gout attacks your Podiatric Physician may refer you to your
primary care physician for long term uric acid management.
In cases where high levels
of uric acid crystals are allowed to build up within a joint (tophi),
surgical removal may be indicated.
