Why Do I Have Gout?
If you’ve ever woken up with severe, inexplicable pain in your foot – the big toe, in particular – you may have gout. “I’ve had a lot of my female patients tell me the pain of a gout attack is worse than childbirth,” says Robert Hiltz MD, a rheumatologist at Group Health.
What Causes Gout?
Gout, a metabolic form of arthritis, occurs when your body either makes too much uric acid or has a hard time excreting uric acid.
While anybody can develop this condition, it’s more common in men – and in women, after they go through menopause. Gout is also more widespread in people with diabetes, kidney disease, obesity, sickle cell anemia, leukemia and other blood cancers.
Because of its prevalence in the obese population, Dr. Hiltz says regular exercise and maintaining a healthy diet as well as limiting alcohol intake may help prevent gout or manage symptoms in those with the condition. “It’s a huge public health burden on our society because the severity and intensity of pain causes people to not be able to work,” Dr. Hiltz says.
What Should I do if I have a Gout Attack?
Most acute gout attacks can be managed by primary care physicians in an office setting. However, most people, who have never been clinically diagnosed with gout, will end up in the emergency department during their first flare-up because the pain is so severe. “But, that’s obviously a very costly way to do it. It usually leads to additional, and sometimes unnecessary, testing,” Dr. Hiltz explains.
Ways to Manage Gout
Once you have been diagnosed, your doctor will likely prescribe a daily medication such as allopurinol or probenecid to decrease uric acid levels in your blood. However, sometimes starting a urate-lowering drug can actually accelerate an acute gout attack, and therefore, your doctor may suggest taking a non-steroidal anti-inflammatory drug, like naproxen or ibuprofen at the same time to prevent an initial flare-up.
Until you adjust your medications appropriately for managing symptoms, Dr. Hiltz recommends having your uric acid levels checked every six to eight weeks. After that, checking uric acid levels once or twice a year should suffice.
Other diet and lifestyle changes that may help prevent attacks include:
- Exercising daily
- Limiting alcohol intake
- Limiting your intake of red meat and sugary beverages
- Losing weight
- Maintaining a healthy diet consisting of dairy products, vegetables, nuts, legumes, fruits (not high in sugar) and whole grains