‘Tis the season…for holiday eating? No doubt over the past few weeks and perhaps even continuing into the present week, you might have consumed a few Christmas hams here and there.
Accompanying these hearty meats and tasty treats, you might
have also washed it all down with some delicious red wine. Finally, your great aunt
might have decided to bring out an exotic shellfish dish to add to the holiday cuisine
this year. As usual, you sink your teeth into the savory delight of yet another holiday
feast. The days following these happy holiday dinners, however, aren’t as joyful. In
the middle of the night, an intense pain in your big toe suddenly awakens you. You
stumble out of bed, hobble into your bathroom, and notice that the joint is red,
swollen, and warm to the touch. You wonder what you ever did to deserve this
immense amount of pain! You take two aspirin, try your best to stomach the pain,
and head to your local podiatrist in the morning.
What you experienced was a gout attack. Gout is a build up of uric acid in a
joint. As in the case of the scenario above, the joint most commonly affected is the
big toe. Gout is either a result of overproduction of too much uric acid or too little
secretion (through urination) of uric acid. This uric acid loves to collect in joints and
crystallize when there is a decrease in temperature (ever notice how your feet tend
to be cooler than the rest of your body?). Even though the joint in the toe is a
popular spot for gout attacks, they can actually happen at any joint in the body.
What puts someone at risk for gout? Medical conditions such as high blood pressure
or diabetes, obesity, gender (more common in males), family history, or the
consumption of beverages and foods high in purines can trigger an attack of gout.
This was the case for our scenario above. Once your gout attack has been confirmed,
what is the treatment plan? It’s important to first avoid those same foods high in
purines that precipitated the initial attack, so make sure to monitor your holiday
meals. It’s also essential to get enough water so that you are continually hydrating
and monitoring your system. Your doctor will also prescribe some medications to
treat the pain and inflammation. Keeping these things in check, you’re sure to have a
happy holiday!
William E. Donahue, DPM, FACFAS
