As of 2008, more than 6 million adults reported having had at least one attack of gout, a complex form of arthritis, at some point during their lives, according to a National Arthritis Workgroup report published in the January 2008 issue of "Arthritis and Rheumatism." Typically, gout sufferers experience sudden, severe attacks of pain, redness and tenderness in the joints, most often at the base of the big toe.
Purines
Purines, a source of nitrogen, come from within the body as well as from certain foods, according to Timothy S. Harlan, M.D. High purine foods include liver, mushrooms and asparagus, anchovies, sardines, mackerel, herring, scallops, mussels, gravies, yeast and mincemeat. Beer and alcoholic beverages also contain high levels of purines.
Uric Acid
Uric acid, a chemical produced by the breakdown of purines, normally dissolves in the blood and passes through the kidneys into the urine. Hyperuricemia occurs if the body produces too much uric acid or cannot excrete enough. When uric acid builds up, it can form sharp urate crystals that accumulate in a joint or surrounding tissues, causing the pain, swelling, and inflammation of gout, according to the MayoClinic.com. Medical causes of uric acid buildup include kidney disease that prevents waste product elimination, hypothyroidism, psoriasis, hemolytic anemia, and some cancers, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Certain medications increase the likelihood of developing gout including diuretics, low-dose aspirin, cyclosporine and levodopa.
Risk Factors
Risk factors for developing gout include age, gender, family history and lifestyle choices. Approximately 20 percent of gout sufferers have a family history of the disease. Gout occurs more often in men than in women before menopause but the incidence of gout in women rises after menopause, according to the National Institute of Arthritis and Musculoskeletal and Skin Disease. Drinking more than one or two alcoholic drinks per day interferes with uric acid removal, increasing the likelihood of developing gout. Excess body weight and eating a diet high in purine-rich foods also increase the risk. Exposure to lead may also cause gout.
Treatment of Gout
Treatment depends on the stage of the condition. If you have high levels of uric acid in your blood but no symptoms, you probably will not need treatment, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. During an attack, called the acute stage, your patient will prescribe medication, such as non-steroidal anti-inflammatory drugs, corticosteroids or colchicine, to manage the pain and prevent permanent damage to the joints. During the interval between attacks, which often lasts as long as a year, treatment focuses on prevention by losing weight, avoiding purine-rich foods and taking medications to lower the uric acid level in the blood. If you do not receive effective treatment for gout, you may reach the chronic tophaceous stage within about 10 years; this is the stage at which the joints and sometimes the kidneys show evidence of permanent damage.
Low Purine Diet
A low purine diet -- also called a gout diet -- can help prevent gout attacks or reduce the severity of the symptoms. Although not a treatment for gout, the diet helps to control the amount of uric acid produced in your body and helps eliminate it, according to MayoClinic.com. Reducing the amount of uric acid in the blood prevents crystals from forming and damaging the joints. To follow the diet, avoid foods that contain 150 to 825 mg of purines per 100 grams, including organ meats, game meats, mincemeat, yeast, gravies and some fish, according to Dr. Harlan. Limit foods with moderate amounts of purines -- 50 to 150 mg of purines per 100 grams -- such as oatmeal, wheat germ, asparagus, cauliflower, spinach, mushrooms, peas, red meat, poultry, fish, shellfish, dried beans, lentils, meat soups, beer and alcohol. You may eat low-purine foods freely, including most fruits and vegetables, grains, eggs, nuts, peanut butter and low-fat or nonfat dairy products.
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