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Your Health: Understanding gout

Dr. Rawad Nasr

Q. What is gout?

A. Gout is a type of arthritis caused by uric acid crystals that form in your joints. Uric acid normally dissolves in your blood, goes through your kidneys and colon, and then out of your body through your urine and stools. When uric acid doesn't flow through, it builds up and can form sharp crystals in the joint or in the space around the joint, causing inflammation and pain. The affected joint becomes swollen, red and feels hot. Symptoms often begin at night.

Q. What parts of the body does gout affect?

A. The big toe joint is most commonly affected, but gout also occurs in the joints of the feet, ankles, knees, hands and wrists. Sometimes it can also affect the elbows and the shoulders.

Q. Who gets gout?

A. Any male or female can get gout but men are more prone to developing it. Women are more likely to develop gout after menopause. Having high cholesterol, diabetes, hypertension, kidney disease, and/or being overweight increase your risk. Gout can be hereditary. It also may be caused by some medications you are taking. Consuming a diet rich in purines and drinking large quantities of alcohol increase your risk of a gouty attack. Purines are natural substances found in all the body's cells and in nearly all foods. Types of purine-high foods to avoid include salmon, mackerel, sardines, shellfish, organ meats, asparagus, mushrooms, herring and yeast.

Q. What is a gout attack?

A. Gout often comes on suddenly and these attacks can be acutely painful and can last several days. If you have a gout attack, avoid alcohol usage completely and don't eat foods high in purines. Drink lots of water and fluids to help flush the uric acid out of your body. Ice packs on the joint can be helpful. Keep weight off the joint as much as possible. You can use over-the-counter medications to reduce inflammation and pain.

Q. How long does gout last?

A. Without treatment, a gout attack can last for days or even weeks. Your physician can prescribe medications to help stop the joint swelling and pain. Your doctor can also prescribe medications that decrease the amount of uric acid in your body to prevent future gout attacks.

Q. What happens when gout isn't treated?

A. If you continue having gout attacks, more joints are likely to become affected and the length of the gout attacks will increase. Over a period of years, you may also develop uric acid crystals that form lumps under the skin (tophi) on the toes, fingers, hands and elbows. Kidney disease can develop and kidney stones may collect in the urinary tract. Even the bone around a joint can eventually be destroyed by recurrent gout.

Dr. Rawad Nasr is a rheumatologist at Sanford Bemidji Clinic. Nasr received his medical education at the American University of Beirut in Beirut, Lebanon. He completed a residency at the same university and then moved to the United States, where he completed a residency program at Hennepin County Medical Center in Minneapolis and also served as chief resident. Nasr went on to be awarded a rheumatology fellowship with the University of Minnesota. He is certified by the American Board of Internal Medicine and board eligible by the ABIM in rheumatology.