Gout

By Kimberly Lopez RN, BSN, MSNc 

and Mia Watkins RN, BSN, MSNc

Edited by Shirley Comer

Gout is a type of arthritis that predominately affect older males, but can affect women too.  It is more common in African Americans (5%) than whites (4%) (ncbi.nlm.nih.gov).  It is caused by a build-up of uric acid in the blood; which comes from ingesting purine-rich foods and drinks such as red meat, seafood, fish, poultry, bacon, organ meats, alcohol, and chocolates (arthritis.org).  Someone affected by gout should limit their intake, if not abstain, from these foods and drinks to keep flare ups at bay. 

Risk factors for developing gout are: 1. excessive daily use of purine diet; 2. excessive alcohol usage; 3. male gender; 4. obesity; 5. hereditary; and 5. being African American.

Diagnosis is made based on symptoms, which may include, inflamed joint, (particularly the big toe), pain, and tenderness to attached limb; elevated uric acid in the blood, and synovial fluid analysis.  However, the symptoms of gout are not always obvious.  For example, a person may present with pain in the joints, but no inflammation.  The key is to look at the bigger picture, i.e. diet, lifestyle, history, and risk factors, before making a diagnosis. Aspiration and examination of synovial fluid and blood test for uric acid are done to confirm the diagnosis of gout. 

Treatment for gout includes limited purine diet, NSAIDs, and the prescription drug, colchicine.  Patients should also maintaining adequate fluid intake, reduce alcohol intake, and lose weight if obese.

References

Safe Foods for Gout. (2019). Retrieved April 25, 2019, from https://www.arthritis.org/living-with-arthritis/tools-resources/expert-q-a/gout-questions/food-for-gout.php

Singh, J. A. (2013, February). Racial and gender disparities among patients with gout. Retrieved April 15, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3545402/

Dunphy, L., Winland-Brown, & J., Porter, B.O. (2015). Endocrine and metabolic problems. Primary Care: The Art and Science of Advanced Practice Nursing. Zycowicz, M., South, T., Martin-Plank, L., & Dunphy, L. (Eds.). (4^th ed., pp. 840-919). Publisher: F.A. Davis Company.

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