Gout - What is it, Why it Hurts our Joints and What We Can do to Prevent it An estimated 1 in 30 Canadians and approximately 5 million Americans currently suffer from gout. This disease can have a significant negative impact on an individual’s quality of life and productivity. Research shows that the number of suffers has been consistently climbing over the past two decades. So what is gout, what causes this disease and what can be done to prevent it? Gout is one of the oldest diseases first identified by the ancient Egyptians in 2640 B.C. It is a form of severe inflammatory arthritis that can recurrently affect a few joints, or exist as chronic inflammatory arthritis in which small and large joints are affected (called polyarthritis) in a pattern similar to rheumatoid arthritis. Historically, gouty arthritis was known as the “disease of kings” because it was associated with eating rich foods and excessive alcohol consumption. One of the key contributing factors linked to the development of this disease is hyperuricemia, or a build-up of uric acid in the body. However, although increasing serum urate levels significantly increase the risk of gout, hyperuricemia is more common than gout implying that there may be additional risk factors associated with the development of this painful disease. High uric acid levels occur most commonly as a result of excess uric acid production in the body, or inefficient excretion of the acid in the urine. Certain genetic disorders may also cause hyperuricemia, but these conditions account for a small fraction of individuals suffering from gout. This build up of uric acid in the bloodstream yields to its deposition in the form of sharp monosodium urate crystals in body joints and tissues, causing extreme pain and swelling of the affected areas. To further the “kingly” historical risk factors for gout, a recent systematic review of 53 studies examining the risk factors and prevention of the disease found that alcohol consumption, as well as various dietary factors such as meat intake; seafood intake; sugary soft drinks and high fructose foods are associated with an increased risk of gout. Alcohol increases the production of uric acid as well as prevents its excretion; certain meats, fish, and shellfish are rich in purines, which are broken down into uric acid in the body. Similarly, fructose is the only carbohydrate known to increase uric acid levels in the body. These products thereby amplify the risk of gout and promote gout flares, as do disease states such as hypertension, diabetes, obesity, high cholesterol, early menopause and renal insufficiency. Interestingly, studies have shown that factors such as dairy, folate and vitamin C intake as well coffee consumption were found to lower the risk of gout as well as decrease the rate of gout flares by their abilities to inhibit the metabolism of purines to uric acid, dissolve urate crystals in the tissues, assist with the excretion of uric acid from the body, as well as due to their antioxidant and anti-inflammatory effects. Further, adding mineral rich supplements such as SierraSil®, which help support cartilage and joint function, may provide added pain relief from gout flares. Unfortunately, there is no known cure for gout. Typical initial treatments for this disease involve the use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin or more potent prescription drugs. However, these medications are associated with a number of side effects and do not target the root of the problem, thus should be used sparingly or avoided if possible. Making lifestyle and dietary adjustments such as limiting the consumption of foods high in purines, maintaining a healthy weight, increasing the consumption of nutrient dense products and drinking adequate amounts of water to assist in the elimination uric acid is a healthier and more effective way to control the pain and inflammation associated with gouty arthritis. References: All about gout. Available at: www.arthritistoday.org Choi, H.K., Curhan, G. Soft drinks, fructose consumption, and the risk of gout in men: prospective cohort study. BMJ. 2008;336:309. Fang, Z., Waizy, H. Current concepts in the treatment of gouty arthritis. Orthopedic Surgery.2013; 5(6): 6-12. Singh, J.A., Reddy, S.G., Kundukulam, J. Risk factors for gout and prevention: a systematic review of the literature. Current Opinion in Rheumatology. 2011; 23: 192-202.