Gout: What is this painful disease?

Everyone knows someone with gout, but few people understand the disease. Photo: The Gout

WASHINGTON, May 25, 2013 —The alarm clock rings to signal another day. As you begin the process of awakening, you realize your toe and some of your foot is aflame. The pain is horrific and you know exactly what is: Gout has paid you an evil visitation. You are not going anywhere.

According to the Mayo Clinic, gout is a complex form of arthritis characterized by severe attacks of pain, tenderness, redness and swollen joints, most often in the big toe. However, gout can strike in other joints as well and leave its victim unable to function in a normal fashion or even walk. If it impacts the fingers, the victim cannot write.

Wherever gout strikes, it can disable its victim for up to a week. It usually strikes in the night so the victim awakens unprepared, taken by surprise; a rude awakening. The pain is excruciating and feels like perpetual fire. Simply running a bed sheet over the affected area can cause agony.

Gout is caused by elevated levels of uric acid in the blood. The uric acid crystalizes and the crystals deposit in the joints, tendons and ambient tissues. The resulting pain can be compared to acid poured over an exposed joint.

Gout was historically called a rich man’s disease or the disease of kings because sugar and rich foods were thought to be the culprit. This was some centuries ago when sugar and rich foods were difficult to come by and unaffordable by peasants and the working class.

Gout takes about two to four hours to manifest itself into a joint, usually during sleep when the body temperature is lowest. It can be accompanied by fatigue and fever. There are greater health risks from uric acid formation such as kidney stones, bone erosion and severe renal or kidney issues.

Affecting one to two percent of the western population at any given time, the cause of raised uric acid levels can be related to diet, genetic predisposition or under-excretion of urate, the salts of uric acid.

Ancient thoughts of causation have some truth, as gout is associated with the consumption of alcohol, fructose ridden soft drinks, meat and seafood. Being overweight is an additional significant influence.

Coffee, vitamin C, dairy products and physical exercise decrease gout risk because of their effect in reducing insulin resistance. Insulin resistance is a factor in weight issues, hypertension and diabetes.

Rates of gout have doubled since 1990. Changes are associated with a longer life expectancy, changes in diet, the prevalence of diabetes and high blood pressure.

Medications such as allopurinol and colchicine are used to treat gout. Colchicine has side effects, one being intestinal upset and uncomfortably softened stools. Non-steroidal anti-inflammatories and analgesics can combat gout and in severe cases, steroids such as prednisone are prescribed. Drinking water throughout the day can help but this will cause more frequent trips to the bathroom creating increased pain. There are new medications on the rise.

The term gout is derived from the Latin word gutta, meaning a drop of liquid.

Gout sounds funny; it is everything but.


Paul Mountjoy is a Virginia based writer and a member of the American Psychological Association and the Association for Psychological Science.




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