Gout is a form of inflammatory arthritis that results from an excess of uric acid (a chemical that is created as the body breaks down certain substances in food called purines) in the blood. In people with gout, uric acid crystallizes in the joints causing painful attacks in the affected body part – often, initially, a big toe.
Other joints that may be affected include the ankle, foot or knees, and in severe cases, the wrists, elbows and fingers. Uric acid can also crystallize as kidney stones and can damage the kidneys.
Gout and pseudogout have similar symptoms and reactions, as both are the result of white blood cells enveloping crystals causing chemicals to prompt the inflammatory process. However, pseudogout is caused by crystals formed from calcium pyrophosphate dihydrate (CPPD) and has a different treatment.
Gout is caused by disordered metabolism of purines. You largely get purines from food, and they are essential to the working of the body. Excess purines are normally eliminated in the urine. But sometimes an excess can lead high levels of urate – a breakdown product of purines – in the blood, a condition called hyperuricemia. This can lead to the deposition of needle-like urate crystals in joints.
In severe gout, dietary changes are usually not enough to prevent repeated attacks, and medications are needed to lower the uric acid. However, if you are not taking medication for your gout, and even if you are, it is reasonable to limit your intake of foods high in purines. For the first six months after starting allopurinol for gout, your diet is especially important in helping to prevent attacks.
Those suffering from attacks of gout often need lifelong medications to prevent excess uric acid formation. If your doctor has prescribed colchicine to prevent gout attacks, the attacks will return if you stop the drug. If you are given allopurinol to reduce the uric acid in the blood (to reduce gout attacks) or to reduce the uric acid in the urine (to reduce the risk of uric acid-related kidney stones), the risk returns if you stop the drug.
In an effort to raise awareness about the severity of gout and further explore the connection between gout and diet, HSS is encouraging those who have gout to participate in an online study supported by the University of Alabama at Birmingham. If you have gout, please take a few minutes to answer the survey questions for this study.