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Arthritis and Rheumatism

GOUT - Big Toe

06/01/1999

Question:

My question concerns GOUT in the big toe. My husband had an onset of the gout about a month ago. He had taken the medication that the doctor had prescribed and it cleared up almost immediately. Now is had returned - what is the cause of this disease and what can one do to slow down or stop the onset at once. Thank you.

Answer:

Gout is a type of arthritis caused by the ingestion of monosodium urate (uric acid) crystals by white blood cells in joints. The most commonly involved joint is the big toe but other sites such as the top of the foot, ankle, knee, or hands can be involved. The attacks can occur very abruptly and can be very painful. They usually spontaneously resolve in five to seven days.

There is normally (but not always) an excess of uric acid in the blood caused by the overproduction or failure of elimination by the kidnies. Medicines used to prevent gout attacks either prevent the formation or enhance the elimination of uric acid. However, years may go by between gout attacks. Accordingly, as the uric acid lowering medicines have potential side effects, they are not usually prescribed unless the attacks become too frequent or a person is forming kidney stone or gout tophi.

Tests are needed to determine if a person is making too much uric acid or not eliminating the substance in the kidnies. Your physician could advise you on your proper course.

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Response by:

University of Cincinnati Larry Houk, MD
Professor of Clinical Medicine and Rheumatology
Division of Immunology and Allergy
Department of Internal Medicine
College of Medicine
University of Cincinnati
Larry   Houk, MD