Rich man Poor man
Ouch my toe hurts !!!!
You wake up one morning with excruciating pain in your big toe and it feels like its “on fire”, but you don’t remember injuring yourself the day before. It’s so painful that even the weight of the sheets appears to be somewhat intolerable. What could it be…….
You Could Be Suffering From Gout!
Gout is simply a condition where your body produces more uric acid than it can excrete. When this happens uric acid crystals accumulate in the joints causing inflammation and intense pain.
Gout most commonly occurs in the first metatarso-phalangeal joint or big toe (Hallux) however it can also affect other joints like the ankle, knee, heel, wrist, elbow and fingers. This elevated blood level of uric acid (hyperuricemia) can result from a diet high in rich foods (red wine, port, lobster, crab, and foie gras).
With Kings and Paupers!
Gout loves a drink
Because of the association of “rich” foods, it has been called the “Rich Man’s Disease” or the “Disease of Kings”.
However, gout is also found in other levels of society…. for example regular consumption of grain alcohol may lead to this disease; this is known as the “Poor Man’s Gout”.
Signs & Symptoms
The Five Cardinal signs of acute inflammation
* Rubor (redness),
* Tubor (swelling),
* Dolor (pain),
* Calor (heat)
* Functio laesa (loss of function).
Diagnosis
The diagnosis is usually a clinical one based on the history and symptoms. However your doctor may perform a needle biopsy this involves inserting a needle into the affected joint and drawing fluid for microscopic analysis. This will often rule out any joint infection as a result of bacteria. Doctors may also recommend a blood test to measure the uric acid level in your body. However, blood tests can be misleading as some people with higher uric acid levels never experience gout.
Treatment
Treatment of this condition usually involves medication. In the first instance non-steroidal anti-inflammatory drugs (NSAIDs) are used to control the inflammation and pain. If more frequent attacks occur your doctor may recommend other medications to reduce your risk of attack.
Prevention - the miracle of water!
Prevention is a key strategy and should include appropriate medications as prescribed by your General Practitioner but also cutting back on rich foods such as red meats, seafood, offal and alcohol. You should also stay well hydrated to help to dilute uric acid in your blood, so it is important to drink enough water every day.
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