What does Diego have? Gouty Arthritis!
Written by: Marcos Otero, Retired Physician Associate
Our Patient Today
Diego looked at his hand as it throbbed. It was swollen. He would get shooting pains when he moved the second and third fingers. He was in agony. This had not occurred in several months. He could not straighten out the fingers of his right hand because of the pain. Even light touch caused significant discomfort.
Normally this occurred on the big toe but over the last years, it started to involve all of his joints. Flare-ups occurred after having consumed alcohol. But it would also happen when he ate shellfish or large amounts of red meat and protein. Also, he could not drink diet sodas without problems.
Classic presentation.
After a weekend of eating and drinking the afflicted will be awoken with intense pain in a joint usually the great toe but can be any joint. Since it is a salt it tends to be deposited in dependent joints like the feet and hands.
Gout was first documented by the Egyptian Pharisee. Know at first as the “rich man’s disease”. Gout afflicted only those who has access to high protein foods and alcohol. Prior to the 20th century this excluded the common man as access to these products was limited by financial resources available.
Uric Acid the culprit!
The cause is high concentrations of Uric Acid. Purine is an amino acid that is a building block of DNA – the primary genetic material in our cells. Purine is metabolized and broken down into uric acid. Uric acid is a crystal or salt that we urinate out. Excessive amounts of uric acid in our blood stream can cause the crystals to be deposited into the joints. The salt deposited cause damage and inflammation of the joint surfaces which causes intense pain and joint destruction.
Purine is found naturally in all foods.
Purine is found naturally in all foods. However, there are certain foods that are higher in purine concentration. The higher the purine content the higher the conversion to uric acid. These foods are high protein foods like red meats and seafood. Alcohol is also very high in purine. Aspartame is used in artificial sweeteners found in diet sodas and products and is composed of 50 percent phenylalanine, 40 percent aspartic acid (both amino acids), and 10 percent methanol. It is also converted into uric acid.
Prevention
Prevention, of course, involves limiting purine-rich foods, alcohol, and diet products. Staying hydrated also helps diluted then uric acid concentration.
See other foot problems: Common Foot Pain Causes
