Martina Ziegenbein, M.D.
Rheumatology
Sees patients at Marshfield Clinic Minocqua Center
I’ve seen a lot of advertising for gout medication recently. What is gout and what causes it?
Gout is a form of arthritis caused by deposits of uric acid crystals in the joints and other tissues, such as the skin or kidney. Uric acid is produced when the body breaks down purines. Purines are found in certain foods and drinks including liver, mackerel, dried peas and beans, beer and wine.
Normally uric acid dissolves in the blood, is filtered by the kidneys and passes out of the body in urine. If your body produces too much uric acid or the kidneys do not filter enough out, it can build up and form crystals. High levels of uric acid in the blood result in a medical condition known as hyperuricemia. Gout occurs when hyperuricemia results in depositing the uric acid crystals in joints.
In the early stages, which could last for months to years, gout may have no symptoms. A person may not know that deposits of uric acid crystals are occurring. Attacks of gout may start intermittently, in one or more joints. In about half of people with gout, the condition first appears in the big toe, commonly as an unusually painful, hot, swollen, red and tender joint. It is diagnosed when the telltale uric acid crystals are viewed in the fluid of the affected joint. Other joints that may be affected include those of the ankle, elbow, finger, knee and wrist.
Treatment consists of reducing the uric acid level in the blood stream long-term. This may be accomplished with a combination of medication and lifestyle changes. For an acute attack, anti-inflammatory medications or steroids are used to reduce pain and swelling.
Gout can be chronic if left untreated. A diet low in purines is recommended for gout sufferers. Healthy lifestyle choices such as maintaining healthy body weight and limiting alcohol consumption can help in its prevention. Without treatment, gout can result in joint deformity or disfiguration. Painful swelling from the condition can become exhausting.
Gout is being seen more frequently. Factors that increase risk for the condition include: male gender, obesity, alcohol consumption and impaired kidney function. Gout is a metabolic problem, meaning that it results from how your body converts what you eat and drink into energy and how your body uses that energy. You can help in reducing the frequency of gout by watching your weight and how much alcohol you consume.
Research has shown that long-term hyperuricemia is linked to higher risk for high blood pressure and heart disease. Gout may be a signal that these underlying conditions are present.
