Gout go away?
March 29, 2011 5:49 PM   Subscribe

Is gout permanent?

I've known a couple people with gout, now one of my cousins has it. He's mid-30s, caucasian, from Jamaica, up until last week ate lots of shellfish and good beers, and in pretty good shape.

His foot started hurting. It turned pretty red. He went to the doctor and got an x-ray. No blood test.

He got put on an anti-inflammatory, told to drink a gallon of water a day, no shellfish beer or whole-grains or "organ meats" (gross), and a day later his foot stopped hurting and the swelling went down.

Anything else he should know? And I am wondering, can a person get rid of out permanently? Thanks, hivemind!
posted by Mike Mongo to Health & Fitness (12 answers total) 2 users marked this as a favorite
My dad gets it (and his dad too, which doesn't bode well for me). Same foods do it for him. He has some medicine he takes for it when it flares up. Cherries are supposed to help, and I've had someone tell me garlic worked for them.

I'm not sure you can get rid of it permanently, but it should go (and stay) away if you follow the right diet.
posted by backwards guitar at 6:02 PM on March 29, 2011

Gout is just a buildup of uric acid crystals in your joints. When you diminish that condition, the gout symptoms go away. Some people are more prone to re-occurrence than others.

Tell him to drink more water and vary his diet a bit more. The doctor probably already told him that. As long as he's otherwise healthy, he probably will be fine. Really, in younger people, I've seen it more often in people who like to party.
posted by mikeh at 6:03 PM on March 29, 2011

Pretty sure it doesn't last. A friend had it and it seemed to be a temporary thing.
posted by jayder at 6:04 PM on March 29, 2011

Best answer: IANAD. Gout can be chronic in the sense that a person can have elevated levels of uric acid in the body and keep painful outbreaks largely under control with diet and drugs like allopurinol and colchicine. I've been on allopurinol and colchicine separately to address gout secondary to renal insufficiency/failure and found that I had only an occasional, mildly painful occurrence. When the root cause of high uric acid levels is treated (in my case with a kidney transplant), the gout attacks should stop too. I still get mild pain in the gout-afflicted joints occasionally and I'm not sure whether I still have uric acid crystals in there that haven't been reabsorbed or whether the joints are just messed up generally.

The good news is that gout is incredibly common and a wide variety of treatments are available. Now would be a good time to get a thorough physical and talk to his physician specifically about the root causes of gout, including kidney problems, if he hasn't already.
posted by Inspector.Gadget at 6:11 PM on March 29, 2011

A few of my family members have it. Essentially, you always have it, but you don't always have a flare-up. There are some meds that you can take daily to prevent flare-ups--several of the aforementioned relatives swear by allopurinol.
posted by willpie at 6:11 PM on March 29, 2011

Speaking from personal experience - I had a gout attack once like your cousin. It was incredibly painful as you have described. Prior to this, I had never heard of gout. I ended up going to the ER because I thought I may have broken my toe. X-Rays were negative and the doc suspected gout. I did get a blood test (a simple blood test can determine the blood uric acid level) and it was, indeed, quite high.

As the doctor described it, susceptibility to gout is genetic and certain foods can trigger an outbreak. The doc prescribed a daily pill for me to take - Allopurinol - which I have been taking now every morning for the past 5 years and have never had a gout attack since. I have noticed zero side effects and the medication is cheap (with my insurance less than $5 a month). So, in effect, this has been a permanent cure for me. I eat/drink whatever I want without a second thought (from the gout perspective, anyway).
posted by blakslaks at 6:18 PM on March 29, 2011

Not entirely clear that he has gout -- IANAD, but for me, a real gout attack would have lasted several days, at least. Also, it's more than just "hurting". A gout attack is incredibly, unrelentingly painful. So maybe it was something else. The only for sure way to diagnose it is to aspirate the affected joint during an attack and analyze the fluid for the tell-tale uric acid crystals. A less intrusive and more common way is to take a blood test (not during an attack) and see if his uric acid levels are elevated.

Assuming he had a gout attack, I'm not sure if you can permanently get rid of the condition, as it usually stems from a reduced ability of the kidneys to excrete uric acid. But he can deal with it and reduce or even eliminate the occurrence of attacks by changing his diet as his doctor says and drinking more water, and if necessary taking a medicine like allopurinol (which limits the body's ability to make uric acid, thereby lowering blood uric acid levels) for an extended time. He can deal with attacks by taking medicines like colchicine or an NSAID.
posted by odin53 at 6:25 PM on March 29, 2011

My first gout attack was on my honeymoon in September 2008. Copious amounts of shellfish, meat, and booze must have put me over the edge. Since then I've had 4 more. Since then, I've found out that my brother and dad both have gout. We're filipino, which apparently is a good predictor of who gets it. Gout sucks.

Here's some information from the American Medical Association [pdf] that you can give to your friend. While gout is caused by uric acid crystals, high levels of uric acid in the blood isn't a reliable indicator of one's chance of having gout.

Anecdotally, cherry juice is supposed to help. My course of treatment was colchicine, but that ended up making me sick and not doing much for the pain. It took ibuprofen 800mg x 3 times a day, a gallon of water a day, abstaining from all meats, and 3 months until my latest attack subsided. I also had to change high blood pressure medication because it also contributed to gout. Friends and family have had good luck with allopurinol. I'll probably get on it if/when I have another attack.
posted by photovox at 6:34 PM on March 29, 2011

Susceptibility is permanent, I believe, though IANAD.

After a few bad flares, I started taking colchicine daily -- .6 mg morning, .6 at night. In the last few years I've felt only one flare approaching (yes, you can feel it before it hurts). Then I took the recommended dose for flares, and it never came on.

One foot doc was surprised I would take this drug to prevent gout, rather than treat it. But as another doctor said, "I bet he never had gout."

It's a terribly painful disease, but colchicine has protected me pretty well.
posted by LonnieK at 6:36 PM on March 29, 2011

That last wasn't perfectly precise. The foot doc was surprised I would take colchicine daily to prevent gout, not that I would take it when I felt a flare approaching. In fact, that's the main indication for the drug: take it when you feel a flare coming on.

So that's preventive. But taking it daily is preventive in a different, and less common, way.
posted by LonnieK at 6:45 PM on March 29, 2011

Best answer: One rat anecdata. I had two attacks, both in the same toe. One in 1990, one in 1991. None since. Never took any medication. I have 7-10 drinks a week (usually wine, rarely beer). I'm semi-vegetarian pescatarian (fish once-twice a week, meat only on special occasions, like trying an exotic dish at a restaurant), No special measures otherwise. But I've also been on CRON for the past 12 years or so. For the past 15 years, I have had regular blood tests during my yearly physicals, and I have not had elevated uric acid during that time. So, if tendency to gout is permanent, then I guess I still have it, but also I have not had an attack now for 20 years. Does that count as "going away"?
posted by VikingSword at 12:27 PM on March 30, 2011 [1 favorite]

Response by poster: YOU ALL RULE! This is great information. By the way, after I forward all of this to Cousin, I would not be surprised if we get a new Mefite. Thanks again, hivemind!
posted by Mike Mongo at 8:20 PM on March 30, 2011

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