Gout: One of the oldest recorded medical conditions — article by Scott Keith
Posted Jun 24 2010 12:04am
Printer, scientist and founding father of our country, Benjamin Franklin, had this condition. It’s believed the cantankerous one himself, Henry the VIII of England, suffered from it. Gout is not just associated with public figures who lived rich lives centuries ago. Gout is, unfortunately, alive and well today and affects about five million people in the United States.
Dr. N. Lawrence Edwards, chairman of the Gout and Uric Acid Education Society, specialist in rheumatology and professor of medicine at the University of Florida, Gainesville, says, “Hippocrates used to write a lot about gout…he already had figured out a lot of the clinical correlations and aspects of gout…it is probably one of the most frequently, or most commonly written about medical conditions in the ancient literature.”
Edwards, in an interview with Men and Health: It’s a Guy Thing, says gout is a form of inflammatory arthritis. While arthritis causes pain in the joints, “this is unique…without question the most painful form of arthritis. It’s a disease that comes on suddenly, which distinguishes it from most of the other types of arthritis.” The joint becomes swollen, red and tender. Early on, the disease strikes lower extremity joints, such as toes. But ankles and knees can be affected by the pain. “People just won’t get up and walk around. Hippocrates called it the ‘unwalkable disease,’” says Edwards. Intense pain can last several days. Symptoms can go away, but early in the disease course, gout can return, perhaps several months later and in a different joint. With advanced gout, “that pain gets worse and worse, and more debilitating, and with this advanced stage of gout, lot’s of joints can be involved,” says Edwards, adding that in the worst cases, gout can become so painful that people can become sedentary and die of pneumonia.
According to Gouteducation.org, “Gout is caused by an accumulation of sodium urate crystals in the joints. The crystals form when the amount of uric acid in the body reaches an abnormally high level.” Genetics can play a role, as can obesity, heart disease, diabetes and kidney disease. Gout can occur in all age groups, but, according to Edwards, it’s very rare in people under the age of 35. “The youngest patient I’ve ever seen with gout was 2 years old. They’re born with a condition that causes them to accumulate uric acid rapidly.” Edwards says the target group is men between the ages of 35 and 55. With gout, “it’s usually an overweight person, maybe somebody that imbibes a little too much, but that’s not necessarily the case.” Because of estrogen’s effect on the kidney to excrete uric acid, women are usually protected through most of their middle ages; women are more likely to suffer from gout after menopause. Says Edwards, “The incidence of gout in later years is pretty equal in males and females.”
The Gout and Uric Acid Education Society is spreading the word about gout, one of the oldest recorded illnesses…going back to 5 B.C. “If you ask primary care physicians, most of them would have some awareness of gout. It’s one of the more poorly treated forms of arthritis…there hasn’t been much of an educational approach in 50 years.” Through the society, Edwards gets the chance to talk with primary care physicians.
As with conditions such as cholesterol, high blood pressure and diabetes, patients need to be informed, so they can communicate with their doctors. Edwards says, “that kind of pressure back on physicians is very good, and with a disease like gout, it’s necessary.”