Gout and Pseudo-gout

 

Gout is a recurrent arthritic condition mostly affecting the big toe, but can also affect the instep, ankle, knee, wrist and elbow. Gout differs from other forms of arthritis because it is caused by the deposition of monosodium urate crystals directly in the joint and around the affected joint and tendons. These crystals are a result of supersaturated hyperuricemic body fluids. It is an inflammatory reaction to these crystals that causes the pain of gout. In times past, this was a disease that affected the rich segment of the population because they were able to eat the types of food that caused gout. Today there are over 2 million people that are affected with gout. Both men and women are prone to the disease. Women are usually affected after menopause.

 An acute attack of gout can come on suddenly. The attack may be precipitated by an overindulgence of certain foods, alcohol, or a trauma due to ill-fitting shoes. It can also be caused by stress or a genetic disposition. The area that is attacked usually is throbbing, inflamed, red, shiny and swollen. The acute attack can last a few days, and the patient is in excruciating pain. If the condition is not taken care of with some form of intervention, the attacks can become more frequent, and will eventually develop into a chronic phase of the gout.

 The individual should seek a definitive diagnosis from their healthcare provider as quickly as possible, at which time a prophylactic therapy can be started. This diagnosis can easily be made through examination, x-ray and a blood test showing a high serum blood level of uric acid. Everyone has uric acid in the blood, and that uric acid comes from the daily turnover of cells in the body. However, it’s only when the levels reach too high proportions that these crystals will find their way into joints. Without this intervention, you can be sure that after the initial acute attack, the acute attacks will become more frequent and the chronic phase will start. The longer the condition is left unattended, erosion within the joint can occur and deformity of the joint can develop.

 If the condition is left unattended in its early stages and allowed to progress, it can cause severe kidney damage and can prove life threatening. A simple explanation of gout is that it caused by an excessive amount of uric acid in the blood. This uric acid needs to be eliminated by the kidneys. When there is a problem of elimination of the uric acid, it then finds its way to a joint as mentioned above. There are usually two reasons for excessive accumulation of uric acid in the blood. One is that the body is forming too much uric acid, and the other is that the kidneys are not eliminating it properly and fast enough, causing the over abundance of the uric acid in the blood. 

 Pseudo-gout is a condition that is similar to Gout; however, a different type of crystal in the blood causes it. These are calcium pyrophosphate crystals. Psuedo-gout usually affects the older individual, whereas gout can affect people at much earlier ages. Pseudo-gout can be caused by other underlying conditions such as thyroid or parathyroid disease. Psuedo-gout is more easily treated than gout with the use of anti-inflammatory drugs (NSAIDS) that are generally found over the counter. Gout generally is treated with prescription medications that break down the protein causing the uric acid.

 There are certain diet restrictions to follow if the individual has gout, psuedo-gout, or is predisposed to either of these diseases.

1. Alcohol, especially beer should be avoided.
2. Bacon can prove troublesome.
3. Organ meats such as liver and kidney.
4. Sardines and anchovies.
5. Mushrooms.
6. In the bean family, avoid lima beans and kidney beans.
7. Spinach.
8. Anchovies.

 In addition to avoiding the above foods, it is important to sip water throughout the day to keep the kidneys flushing the uric acid crystals out in the urine to keep them from entering the blood.