Gout is On The Rise. Does Heredity Put You At Risk?
Gout used to be called the “disease of kings.” Charlemagne had it, formerly athletic Henry VIII lost his mobility and even Leonardo da Vinci and Benjamin Franklin suffered from this agonizing form of inflammatory arthritis.
But now, cases have doubled in the last 10 years, with people as young as their 20s or 30s developing it, where formerly gout was usually diagnosed in men over 40.
Gout happens when excess uric acid in the blood forms needle-like crystals in the joints, usually the toe joints. This is as painful as it sounds. Gout can become chronic if the uric acid keeps forming crystals and causing permanent joint damage.
Some people may have only one attack which lasts about 10 days, while others develop chronic attacks – in fact, about 60 percent of sufferers will have another attack within a year. 84 percent will have another attack within three years.
What’s Causing a Rise in Gout Cases?
There a variety of factors scientists and doctors believe have led to the rise in gout cases. In the U.S. and U.K., we’re eating more red meat. Fructose is added to more processed foods. And there’s been a big rise in beer consumption and binge-drinking. (Oddly enough, wine and spirits don’t seem to affect gout as much.) Medications like beta-blockers and diuretics are used more often.
The Genetic Factor
In the U.S., about eight million people a year develop gout. Men are more susceptible than women, but after age 60, women tend to catch up. Heredity definitely plays a part in gout. If someone in your family has it, you could be up to 80 percent more at risk. A U.K. study showed that 40 percent of gout patients had a family history of the disease. So it’s to your advantage to develop good dietary habits to decrease your risk.
Gout can affect any joint, but usually starts in the big toe. The first symptoms present when the toe becomes swollen, shiny, red and warm. It might not hurt – yet. But within a few days, or even hours, that changes. Many people simply wake up in such pain that they can’t even bear the weight of bed covers. Putting on your shoes is painful. Driving may become impossible. Any weight at all on your foot is agonizing.
The first thing you can do is take NSAID pain relievers such as aspirin, ibuprofen (Motrin IB, Advil, Nuprin), naproxen (Aleve) or ketoprofen (Actron, Orudis KT). These aren’t cures or long-term treatments, but they can help the initial pain.
The earlier your diagnosis, the better, so call your doctor immediately. Say that you suspect you have gout, because he or she may want to refer you to a podiatrist who can recognize gout immediately and start treatment.
Treatment and Management
The first treatment is usually an injection of corticosteroids directly into the affected joint. This might sound painful, but in a few minutes, you’ll feel much better as the pain calms down. The second stage of treatment is usually Colchicine, a pill that you’ll take every day for a limited time. The third stage is another pill, usually Allopurinol. This helps your body eliminate uric acid, and is usually the preferred long-term treatment.
Regular blood tests can also be used to monitor uric acid levels.
How You Can Lower Your Risk
Gout comes on suddenly, but uric acid takes time to form crystals. It’s usually excreted through the kidneys, but some people run into roadblocks getting rid of it, either due to medical conditions, heredity (which you can’t help) or lifestyle (which you can change).
Some medications for heart disease, high cholesterol, blood pressure, diabetes, rheumatoid arthritis or psoriasis can interfere with the elimination of uric acid. Gastric bypass surgery also puts you at risk. If you take these medications, ask your doctor if any of these meds can be changed or adjusted.
Keep alcohol to no more than two drinks or two beers a day. Avoid red meat, shellfish and foods/drinks with fructose.
To learn more about gout, visit http://www.arthritis.org
Think you may have gout? Please contact us by calling (281) 586-3888 or filling out an appointment request to schedule an appointment with a doctor in Houston today.