Gout

The majority of the time the podiatrist is not the initial doctor that a person goes to see when having a problem. They often see their primary physician first and are referred to the podiatrist. In the case of gout often times it’s the opposite. This is because gout usually manifests itself first in the foot. The patient will go to see the podiatrist first due to pain in the foot. Not realizing that there is a disorder that involves the entire body.

Gout is a disorder caused by an increased level of uric acid in the system. This uric acid forms crystals which are deposited into the joints. These crystal deposits cause extreme inflammation and pain. Usually the onset of this pain is very sudden and the majority of the time at night. The uric acid levels are increased due to a high number of purines in the system. Certain people are predisposed to gout due to their overproduction of purines or inability to clear the purines from their system. Purines are a type of protein which we get from different foods. Certain types of foods and drinks which are high in purines can cause a sudden gout attack. Below is a list of foods that are high in purines:

Foods very high in purines include:

  • hearts
  • herring
  • mussels
  • yeast
  • smelt
  • sardines
  • sweetbreads

Foods moderately high in purines include:

  • anchovies
  • grouse
  • mutton
  • veal
  • bacon
  • liver
  • salmon
  • turkey
  • kidneys
  • partridge
  • trout
  • goose
  • haddock
  • pheasant
  • scallops

When a gout attack occurs it often affects the big toe joint. The patient will present to the podiatrist office relating extreme pain, redness, swelling in the big toe. This will have to be differentiated from other disorders which have similar symptoms. However, it is not difficult to diagnose a patient undergoing a gout attack. Once the diagnosis has been made significant, often total, relief can be achieved through anti-inflammatories. In severe cases more aggressive treatment may be needed.

After resolution of the initial attack’s symptoms it will be important to follow-up with the primary physician for analysis of the cause of the increased levels of uric acid. Gout attacks can be resolved fairly quickly. However, each attack can cause permanent damage to the joint and arthritis down the road.

To prevent a gout attack, try to avoid the foods listed above. If your family has a history of gout it may be recommended to have your uric acid levels checked by your physician.