Gout is like arthritis, but instead of coming on over months or years, gout shows up one day as severe pain, redness, and tenderness. In 90 percent of initial cases, it appears in the largest joint of the toe. As it progresses, however, it can show up in any number of joints. Telltale markers of advancing gout are the uric acid lumps, called tophi, which appear under the skin next to affected joints.
Uric acid builds up from eating too much red meat, or drinking too much alcohol, or from dehydration. When an individual has inflammatory bowel disease, which interferes with water distribution, gout may be the result. Gout also affects more men than women, and is usually diagnosed on appearance although most doctors will also take X-rays and test urine for excess uric acid crystals.
The most common complaint amongst gout patients is a lack of effective remedies to relieve the almost excruciating pain. Among doctors, the complaint is that their gout sufferers rarely schedule office visits for follow-up care, even though gout affects 65 percent more people than rheumatoid arthritis. Most doctors now agree that up to 80 percent of gout is genetic. The tendency toward gout increases with age and overweight, and rises with purine and alcohol consumption, but can also be triggered by high blood pressure, underactive thyroid, psoriasis, hemolytic anemia, an organ transplant, and even some cancers.
Doctors treating gout will prescribe diuretics to reduce the amount of uric acid, salicylates like aspirin, niacin (also known as vitamin B-3 or nicotinic acid), cyclosporine to reduce the immune-system response that is part of gout, and Levodopa, also used to treat Parkinson’s disease.
The most significant advance in treating gout so far has been the identification of foods that affect gout. Doctors now know that consuming large amounts of low-fat dairy products cuts the risk of gout by 50 percent. Citric acid is another likely candidate.