VANCOUVER -- Gout is a form of arthritis that's characterized by bouts of severe pain, so bad, people can't even stand the weight of a bedsheet on their affected joints. It's caused by the deposit of uric acid -- an end-product of metabolism in the joints. Since the 1970's, the rate of gout has doubled and that's got researchers working to find ways of tackling the growing problem.
Rob Williamson suffers from gout. He says, "gout is something people don't want to experience."
Williamson says his finger enlarges three times, that's how bad it gets. Two or three times a year, his gout flares up.
In Rob's case, his gout is the result of his heart transplant 13 years ago and the medication he's on. In others, the disease is related to obesity.
Dr. Hyon Choi, Rheumatologist with the Mary Pack Arthritis Society and Chair of Rheumatolody at UBC says, "it increases the production of uric acid because of the fat tissue associated with obesity. Also, obesity is associated with lower excretion of uric acid in kidneys."
It's that increased production and lower secretion of uric acid that leads to gout. While men are more affected by gout, women quickly catch up after menopause with rates reaching one in 20.
Dr. Choi says, "estrogen appears to have a role in lowering uric acid levels, so after menopause women have lower estrogen level, so they have a higher uric acid level, which puts them at a higher risk of developing gout."
Foods high in purines can also tip the balance with gout: because our bodies readily transform the substances into uric acid.
A large study done in ment found purine rich foods like red meat and seafood did increase the risk of gout, but purine rich vegtables did not.
Dr. Choi says, "actually, the risk was other way around. It was somewhat protective against the risk of gout, so those vegtables should be recommended."
Alcohol can make matters worse.
Rob says, "I love a glass of red wine and I love seafood, shellfood, I'm my own worst enemy."
Rob though does watch his diet from time to time and use medication to help prevent and treat flareups.
"You gotta live too and it depends how often you want to put up with the pain.
Some other risk factors for gout include hypertension and the use of low-dose aspirin and diuretics. Weight reduction can lower your risk of gout, and so can dietary changes, such as increasing your intake of vitamin C and low-fat dairy products. For some people with very high uric acid levels, medication may still be required.
Wednesday May 10, 2006
