Text by Henrylito D. Tacio
WHAT do Benjamin Franklin, Alexander Hamilton, Isaac Newton, Thomas Jefferson, and Christopher Columbus have one thing in common? They were some of the wealthy and exalted victims of gout, that’s what.
Known as “the disease of kings and the king of diseases,” gout has been studied by physicians and has caused suffering in countless humans, at least since the days of Hippocrates. Formerly a leading cause of painful and disabling chronic arthritis, gout has been all but conquered by advances in research. Unfortunately, many people with gout continue to suffer because knowledge of effective treatments has been slow to spread to patients and their physicians.
Recent studies have shown that gout still afflicts the rich more often than the poor, but it now strikes people under 50. Ninety-five percent of those who suffer from gout are men. And women who acquire it are usually those who underwent surgical removal of their female organs or have gone through menopause.
According to medical science, gout is one of the most painful rheumatic diseases. It results from deposits of needle-like crystals of uric acid in connective tissue, in the joint space between two bones, or in both. These deposits lead to inflammatory arthritis, which causes swelling, redness, heat, pain, and stiffness in the joints.
If you care to know, the term “arthritis“ refers to more than 100 different rheumatic diseases that affect the joints, muscles, and bones, as well as other tissues and structures. Gout accounts for approximately 5% of all cases of arthritis, medical studies show.
For many people, gout initially affects the joints in the big toe. Sometime during the course of the disease, gout will affect the big toe in about 75 percent of patients. It also can affect the instep, ankles, heels, knees, wrists, fingers, and elbows.
The disorder also tends to be hereditary as it runs in families. This means that if your father or uncle suffers from it, there’s a strong chance you will have it, too. Taking certain antibiotics, thiazide diuretics, and anti-cancer drugs may also cause gout. Recent studies show that obesity, diabetes, and hypertension, and diabetes may also be a factor in developing gout.
Attacks of gout occur without warning. Typically, severe pain occurs suddenly in one or more joints, often at night; the pain becomes progressively worse and often is excruciating. The joint swells and the skin over the joint appears red or purplish, tight, and shiny, and it feels warm. Touching the skin over the joint can be extremely painful.
Ask my brother Gerry, who has been afflicted with gout since he was 24. He describes gout pain as crippling. “It’s like 1,000 knives stabbing you all at once,” he told me. “You can’t sleep for days, and when you do, it’s only for short periods.”
Other symptoms of gout can include fever, chills, a general sick feeling, and a rapid heartbeat.
According to The Merck Manual of Medical Information, the first few attacks usually affect only one joint and last for a few days. The symptoms gradually disappear, the joint’s function returns, and no symptoms appear until the next attack. However, if the disorder progresses, untreated attacks last longer, occur more frequently and affect several joints. Affected joints may be permanently damaged.
There is no cure for gout, but pain and other symptoms may be relieved with medication. In its Guide to Prescription and Over-the-Counter Drugs, the American Medical Association (AMA) bares several drugs used to treat acute gout. Colchicine can halt an attack of gout; non-steroidal anti-inflammatory drugs (NSAIDs) may also ease the symptoms. “Either type of drug should be taken as soon as an attack begins,” AMA suggests. It is important to note that aspirin should not be used for gout pain relief since it slows the excretion of uric acid.
Drugs used in the long-term treatment of gout are usually successful in preventing attacks and joint deformity. However, response may be slow, and there are side effects such as stomach upsets, rashes, and nausea. Colchicine can disturb the digestive system, causing abdominal pain. Taking it in large amounts and for long periods can also be toxic.
More often than not, doctors tend to favor medication as the first line of treatment for gout. The drugs mentioned above can relieve your symptoms and defend against future attacks. However, there’s a lot you can do on your own to help take the ouch out of gout, medical experts say.
The Doctors Book of Home Remedies recommends the following to get relief fast – and to reduce your risk of a recurrence:
· Give it a rest. During about with gout, keep the affected joint elevated and at rest, says Alabama pathologist Agana Trash. You’ll probably have little trouble following this advice because the pain will be so intense. During this phase, say, doctors, most patients can’t even bear the weight of a bedsheet on the tender joint.
· Apply ice. If the affected joint is not too tender to touch, try applying a crushed-ice pack, suggests Dr. John Abruzzo, director of the Division of Rheumatology at Thomas Jefferson University. The ice will have a soothing, numbing effect. Place the pack on the painful joint and leave it for about 10 minutes. Cushion it with a towel or sponge. Reapply as needed.
· Avoid high-purine foods. “Foods that are high in a substance called purine contribute to higher levels of uric acid,” says Dr. Robert Wortmann of the Medical College of Wisconsin. So avoiding such foods is prudent. These foods most likely to induce gout contain anywhere from 150 to 1,000 milligrams of purine in each 3.5-ounce serving. They include high-protein animal products such as brains, gravy, heart, herring, kidney, liver, meat extracts, mussels, and sardines.
· Limit other purine-containing foods. Foods that may contribute to gout have a moderate amount of purine (from 50 to 150 milligrams in 3.5-ounces). Limiting them to one serving daily is necessary for those who suffer severe cases. These foods include asparagus, dry beans, cauliflower, mushrooms, oatmeal, dry peas, shellfish, whole-grain cereals, whole-grain breads, and yeast. In the same category are fish, meat, and poultry. Limit them to one 3-ounce serving five days a week.
· Drink a lot of water. A large amount of fluid can help flush excess uric acid from your system before it can do any harm. Dr. Robert Davis, a professor of physiology at the Pennsylvania College of Podiatric Medicine, recommends plain old water. “Most people just don’t drink enough water,” he says. “For best results have five or six glasses a day.” As a bonus, lots of water may also help discourage the kidney stones that gout patients are prone to.
· Control your blood pressure. If you have high blood pressure in addition to bout, you have double trouble. That’s because certain drugs prescribed to lower blood pressure – such as diuretics – actually raise uric acid levels, says Dr. Branton Lachman of the University of Southern California School of Pharmacy. So taking steps to lower your blood pressure naturally would be wise. Try decreasing your salt intake, losing excess weight, and exercising. But never discontinue any prescribed medication without consulting your doctor.
· Beware of fad diets. If you are overweight, slimming down is imperative. Heavier people tend to have high uric acid levels. But stay away from fad diets, which are notorious for triggering gout attacks, says Dr. Jeffrey Lisse of the University of Pittsburgh School of Pharmacy in Pennsylvania. Such diets – including fasting – cause cells to break down and release uric acid. So work with your doctor to devise a gradual weight-loss program.
· Ease up on imbibing. “Drinking too much alcohol raises the uric acid level in the blood,” says Dr. Arthur Grayzel, a rheumatologist and former spokesperson for the Arthritis Foundation. You don’t necessarily have to become a teetotaler, he notes. The key is moderation. Take notice of whether you routinely have gout attacks after you have been drinking alcohol.
· Skip vitamin C. At times, it seems that vitamin C is good for anything that ails you. But gout is an exception to the rule. “Avoid vitamin C supplements,” advised Dr. Eric Gall, chairman of the department of medicine at Finch University of Health Sciences in Chicago. “They can hamper the kidneys’ ability to remove uric acids.”
· Wear sensible shoes. A minor injury caused by poorly fitting footwear can trigger a gout attack in your big toe, says Dr. Glenn Gastwirth, deputy executive director of the American Podiatric Medical Association. “Avoid shoes that are too tight or too narrow. You should be able to wiggle your toes freely.”
And here’s a final piece of good news. According to recent reports, frequent orgasms in men lower the uric acid level in the blood and decrease the frequency of attacks!