GOUT AND THE BIG TOE

 1 year ago

written by Scott Zashin, MD


Gout is a common and treatable form of Arthritis affecting more than 2 million Americans 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, lasting 3 to 10 days. Most people believe Gout only affects the big toe. Though Gout is common in the big toe, it often affects other areas. 

Gout Can Affect

  • Ankles
  • Big Toe
  • Elbows
  • Fingers
  • Heels
  • Insteps
  • Knees
  • Wrists

Symptoms Include

  • Heat
  • Pain
  • Redness
  • Stiffness in joints.
  • Swelling

While occurring in men and women of all ages, it rarely occurs in women before menopause. One way to obtain a diagnosis of is to remove fluid from an affected joint and examine it for the presence of uric acid. The diagnosis can also be confirmed by clinical criteria and imaging studies. Finding an elevated uric acid does not mean you have gout. 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 may trigger gout attacks. Certain substances in drugs 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, dark 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. 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 icing the area and elevating the joint, changes in medications or diet it may be time to visit a Rheumatologist to diagnose you accurately and prescribe medication to prevent flare-ups. These medications may include colchicine, Benemid® (probenecid) or Zyloprim® (allopurinol) or Uloric.

Dr. Scott Zashin is a respected and published Dallas Rheumatologist. He is dual board-certified by the American Board of Rheumatology and the American Board of Internal Medicine. Dr. Zashin is the Medical Director of Dallas Rheumatology. For more information on getting back to feeling great visit his website or call today to schedule your initial consultation 214-363- 2812.

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