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Overcome a Gout Bout

by Dr. Stephen Sinatra

Published 04/30/09

Have you ever had a gout attack? I remember my grandparents talking about it when I was a kid, but I didn't understand what they meant until I was 40. I woke up one morning to a big, swollen toe that was so painful I could barely walk! I'll never forget the pain. The dreaded gout had gotten me.

Naturally, as a doctor, I knew this was a very abrupt and painful problem, but nothing hits home like personal experience! After that episode, I had even more empathy for patients who came to me moaning and hobbling-sometimes on crutches because they couldn't bear to put any weight on the affected foot.

Gout is very common. Several years ago, I got an urgent call from my friend, Norm, who couldn't figure out what had happened to him overnight. He asked me what could possibly be wrong. He explained that he woke up one morning to find his ankle puffed up like a balloon and hot to the touch. When he told me that walking was impossible, I knew that he, too, had the dreaded gout.

I told Norm to go to the emergency room immediately, which is exactly what you should do if gout strikes you and you can't reach your doctor. Unfortunately, Norm is also a long-time heart attack survivor, which is a tip off that he's more at risk than most people for gout.

That's right, cardiac patients are more susceptible to gout than the general population. High levels of uric acid (hyperuricemia) are associated with both gout and heart disease. As a cardiologist, you can imagine then I've seen a lot of gout!

The good news is that the emergency room doctor got Norm on the right therapy to relieve his pain-non-steroidal anti-inflammatory drugs (NSAIDs) and sent him home (most folks with gout don't get hospitalized). Before I tell you the best way to deal with gout once the pain subsides, let me tell you what...

Gout Is...

...A form of arthritis, also known as gouty arthritis, which can affect any joint, but seems to have a special fondness for the big toe, ankle, and elbow. Here's what happens: When uric acid builds up in your body, it tends to crystallize and leave sparkly little deposits, which aggravate joint tissue. As joints become more inflamed and swollen, they cause intense pain.

For some reason, gout strikes men more often than women, and it's more problematic after age 30. But two million Americans struggle with gout bouts, so this is a serious problem!

Gout is not just a "tissue issue." It's actually a systemic metabolic disease that knocks you down if your monosodium urate (MSU) blood levels are too high. MSU levels rise when the body fails to make the enzymes to break it down. High levels can also occur when your kidneys fail to eliminate excess MSU. And high levels of MSU mean high levels of uric acid.

Several factors can trigger high uric acid levels and put a vulnerable person over the edge. These include excessive fasting, alcohol, diuretics, organ meats, red meat, poultry, saturated fats and refined sugars. If you've had a gout bout, or if you know you're at risk for gout, avoid these foods.

You should also be aware that foods high in the amino acid purine can increase uric acid and sprout a gout bout. I can identify several dietary sources for my own gout attack. The day before, I ate lamb, barbecued chicken and a few beers. But now I know better, and haven't had a problem since.

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