Podiatry Terms & Descriptions – Gout

What is Gout?

Gout is a condition that results from an increased or overload of uric acid crystals in the body and is nine times more common in men than women. Most often it afflicts men after puberty, with a peak ages of 40-60. When a person has a gout attack, it is typically marked by the following symptoms: Intense, sudden pain, many times beginning in the middle of the night. Significant redness, swelling and increased temperature across the joint making it difficult to even have the bed sheets touch the foot.

What are the Causes of Gout?

Uric acid is a byproduct of certain types of foods called purines, which are contained in many types of foods we eat. Some of the foods which contain large amounts of purines include red meat, red wine, sardines, herring and alcoholic beverages. Some people develop gout because their body naturally overproduces uric acid crystals and other times the kidneys are unable to eliminate normal amounts of uric acid crystals. As the purines overload the body, the uric acid crystals will typically affect the great toe joint of the foot. In other instances, gout can affect the ankle or knee joint. Most often gout and increase the uric acid is inherited. Other factors which may affect a patient include long-term use of high blood pressure medication, including the use of water pills.

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. You may need to change your diet and reduce the amount of some of the gout producing foods and beverages, including decreasing the amount of shellfish, red wine, red meat and other alcohol.

Diagnosis of Gout

The diagnosis of gout is made by your foot and ankle surgeon who will take your personal history and physical and examine your foot. X-rays and laboratory blood tests are often ordered to confirm the increase in uric acid crystals and to determine whether or not there is another cause of the inflammation.

Treatment for Gout

Once you have been diagnosed with gout, oral anti-inflammatory medication is usually prescribed. Within three to seven days most of the symptoms will significantly decrease and you will become more comfortable. Should you experience repeated gout attacks, your foot and ankle surgeon may refer you to your primary care physician who can prescribe a medication to control the daily output of uric acid within your system. Repeated gout attacks can also cause arthritic changes to occur within the affected joints. For this reason it is most important to aggressively diagnose and treat the disease.

When is Surgery for Gout Necessary?

In extreme cases of recurrent gout, surgery may be indicated to remove the accumulation of uric acid crystals and to prevent further damage to the joint. Again, your foot and ankle surgeon will determine whether or not surgery may be indicated.