Gout
A COMMON AND TREATABLE FORM OF ARTHRITIS

Gout affects more than 2 million Americans. It is caused by deposits of uric acid — a white, odorless crystal that accumulates in the body and causes redness and swelling of the joints. Attacks come on suddenly and are painful. The big toe, ankle and knee are common sites of involvement. While gout can occur in men and women of all ages, it rarely occurs in women before menopause.

To obtain a definite diagnosis of gout, fluid must be removed from an affected joint and tested for the presence of uric acid. The reason for a joint fluid test rather than a blood test is two-fold. First, the uric acid level in the blood may be normal even when gout is present. Second, a high level of uric acid in the blood by itself does not necessarily signify the presence of gout.

Medications and diet are often culprits of gout attacks. Certain substances in medications and food can increase levels of uric acid in the blood. Diuretics such as Lasix® and hydrochlorothiazide, which are used to treat high blood pressure and edema (fluid retention), can increase the risk of gout attacks. Aspirin also increases uric acid levels and can worsen attacks.

Foods with high purine levels also increase uric acid levels in the blood. So changing your diet may help to prevent attacks. Avoiding sweetbreads, herring, mussels and sardines can be helpful. So, too, can avoiding alcoholic beverages, especially beer, heavy wines and champagne. Results of a study published in the New England Journal of Medicine indicate that a diet that includes dairy products and vegetables may help to prevent gout.4 Obesity and overeating or “bingeing” have been associated with gout, so maintaining a reasonable weight may also be a preventative measure.

If frequent gout attacks persist despite changes in medications or diet, your doctor may prescribe certain drugs to prevent flare-ups. These include colchicine, Benemid® (probenecid) or Zyloprim® (allopurinol).

The above information about gout is from Dr. Zashin's book, Arthritis Without Pain, a comprehensive guide for patients considering or undergoing treatment with the TNF blockers Enbrel®, Remicade®, or Humira®. All rights reserved.

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