Gout is a form of arthritis that occurs as a result of the accumulation of uric acid in the bloodstream and subsequently joint fluid. This is called 'hyperuricemia'. The accumulation of uric acid typically occurs when the body has difficulty processing certain substances called purines (pure-eens) that are found naturally in our diets.

The actual build-up of uric acid can result when the body has difficulty eliminating uric acid throught the kidneys and urine, or in some cases when the body produces too much uric acid. The tendency to accumulate uric acid is often hereditary. Gout is most commonly seen in males 50-60 years of age but can affect males and females 20-80 years of age. Gout is an acute inflammation of a joint, most commonly seen in the great toe joint and ankle joint. The increased uric acid precipitates out from the bloodstream into the joints of the leg and foot due to gravity. It can however occur in almost any joint in the body. It starts with the sudden onset of intense pain in a joint accompanied by redness and warmth to the touch. Swelling is usually quite significant in the joint affected and may cause the entire foot or ankle to be swollen. It is often difficult to walk on and the pain is usually worse at night. Early on gout does not cause permanent damage to a joint but after several attacks of gout the joint affected can be permanently affected with arthritis. The diagnosis is often based on the clinical appearance of the foot or ankle. Usually bloodwork will show an elevated uric acid level but a normal level does not rule out gout. For the reason that sometimes the uric acid has precipitated into the joint from the bloodstream and allows the uric acid level within the blood to return to more normal levels. In more difficult to diagnose cases your doctor may attempt to remove fluid from the joint affected and send this fluid to the laboratory for analysis. X-rays may also be done to evaluate if any joint damage has occurred.

The treatment of gout often starts with a prescription anti-inflammatory medication to reduce pain and allow the swelling to decrease. Common medications that are prescribed are Indomethacin, Colchicine, Vioxx, Celebrex or Bextra. Usually over the counter anti-inflammatories such as ibuprofen are not adequate enough to reduce the pain and swelling. Untreated gout usually lasts 5-10 days but may last longer and that is why it is important to see a podiatrists or your primary care physician. Do not attempt to treat it yourself. Gout can also be induced by certain medications such as anti-hypertensives, this is another reason to see a physician regarding gout. Gout can also be induced by trauma or surgery in someone who is prone to gout. If a patient has a history of gout and is going to have foot surgery it is important to tell your surgeon. Dr. Still usually gives a medication prior to foot or ankle surgery to prevent a gout attack after surgery in patients who are at risk.

Foods that are high in purines include red meats, shellfish, beer, red wine, salt and certain nuts. Drinking 6-8 glasses of water each day, eating a proper diet and evaluating prescription medications can reduce the likelihood of a future gout attack.