Gout recurrence can be prevented

What happened to you is actually not that unusual. I do believe that, with some diet changes and maybe a visit to your regular doctor, we may have a chance to make another gout attack much less likely.

Gout is a type of arthritis caused by uric acid crystals forming inside the joint or a space between two bones. The most common location for gout is at the base of a big toe, but it can affect other joints as well.

Uric acid is a product of a breakdown of purines -- substances found in foods like beans, asparagus, mushrooms and certain meats and seafood. The most common symptoms of gout are a red, swollen, painful toe or other joint and, for some, fatigue and fever. The intensity is the worst in the first 12 to 24 hours, but the symptoms may continue for weeks. It is important to know that this is a self-limiting illness, which means that it will eventually go away even when not treated by any medication.

Gout affects about 1 to 2 percent of the population in the United States. It is generally more common in men, but it can attack women, especially after menopause. It is a very old disease -- it was known by Egyptians in ancient times. It has been called the "disease of the kings" due to its presumed association with eating certain foods and alcohol.

Now you may ask why exactly the uric acid crystallizes inside the joints. It is due to one of two reasons. There may be too much of the uric acid made by the body, which happens in about 10 percent of cases. But, more often, the kidneys are unable to get rid of the uric acid properly and, as a result, there is just too much uric acid in the blood. The level of uric acid can be measured by a blood test and, to some extent, can guide treatment and diet modifications. Interestingly enough, gout attacks are influenced by outside temperatures, which is why they happen more often in early morning. Uric acid may also crystallize in other parts of the body, causing funny-looking, small, painless lumps around joints and tendons, which doctors call "tophi." Gout is also associated in some people with kidney stones -- again caused by the uric acid.

This disease does run in families, but just because your dad or mom has had it does not mean you will get it as well.

It is also associated with elevated blood pressure, obesity and elevated cholesterol. As we have mentioned before, excessive alcohol use (more than two drinks daily) is one of the risk factors. Some medications can make gout attacks more likely. Simple aspirin and commonly used water pills -- known in "doctor talk" as thiazide diuretics -- have been associated with gout.

On the other hand, coffee and vitamin C, as well as dairy foods and physical exercise, may be protective for gout sufferers. as they lower uric acid levels in the blood.