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The Gout - Podiatry, Pharmacology, & You

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Gout is a problem that often arises in the joint of the big toe. Anyone who has experienced ‘the gout’ can tell you of the excruciating pain that led them to seek out a podiatric physician. While I have never experienced gout myself, many patients have described such a pain sensitivity that they cannot stand to have a blanket touch their toe without wanting to cry out in pain. As a specialist of the foot, a podiatric physician is best apt to help you resolve this painful dilemma with your help and medication. Let’s talk about you and then we’ll get to the medication and recent changes that may affect your ability to get medication.

Gout is the manifestation of your body’s inability to properly process small molecules called purines. It can result from several causes including stress to your body, metabolic stress and eating lots of food. The last cause is why it has long been associated with gluttony and excess. There are more than one woodcarvings from the Middle Ages detailing individuals with this malady eating large portions of meat and big steins of beer. The overload of purine molecules and your body’s inability to excrete them properly create high levels in the blood that subsequently crystallize in the joint. These sharp little crystals floating around in the fluid of your big toe joint are the source of discomfort. An acute gout attack can seemingly appear from nowhere and last for weeks, though often can resolve within a few days if treated properly. Without proper treatment, a gout attack can severely limit your ability to walk and create long standing arthritic changes to your joint.

One of the medications often prescribed for gout treatment is no longer available as a generic. Colchicine was often prescribed for immediate relief as well as preventatively for individuals with frequent attacks. While colchicine has long been available for a few dollars as generic, it was recently given sole FDA approval as brand name Colcrys and subsequently became quite expensive. Your Austin podiatrist can prescribe other medications to help you manage an acute gout attack, but is important to take a look at your lifestyle. Changes to your diet, such as cutting out meat, alcohol, and sodas, as well as drinking plenty of water can help lower uric acid levels in your body and prevent crystals from forming. After recovering from an acute attack, it is important to maintain a healthy weight and implement daily exercise. This is important to keep your body’s metabolism functioning properly and getting rid of these molecules.

Until next time, keep those feet happy and healthy Austin!

Dr. Craig H. Thomajan, DPM, FACFAS, FAENS
Founder and Managing Partner of Austin Foot and Ankle Specialists
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