By: Gary Ho
History of Gout:
Gout, a form of inflammatory arthritis characterized by sudden, severe pain and swelling, has a long and well-documented history. Evidence of this disease can be traced back to ancient Egypt to around 2640 BC, making it one of the earliest recognized medical conditions. By the fifth century BC, Hippocrates—the renowned physician—had studied gout, acknowledging its debilitating nature. He referred to it as the “unwalkable disease,” underscoring the intense discomfort it can cause. Additionally, it was sometimes termed the “king’s disease,” reflecting its frequent occurrence among the affluent of that era, who often partook in diets rich in meats and beer—substances that were less accessible to the common populace.[1]
Why Do People Get Gout?
Contrary to popular belief, gout isn’t all about indulging in high-end cuisine. The real culprit is excess uric acid in the blood, which forms sharp crystals in the joints. Imagine dissolving too much salt in water until no more can be absorbed, and the excess settles at the bottom. That is similar to what happens in the body with gout: the uric acid does not dissolve and, instead, turns into painful, needle-like crystals.[2]
What Are the Causes of Gout?
Understanding gout begins with recognizing the role of uric acid. While indulging in certain foods might contribute to the problem, other factors—such as obesity, family history and genetics—play an essential role in the development of this condition. These elements intertwine to create a complex scenario where uric acid builds up in the blood, forming sharp crystals in the joints, leading to the painful symptoms associated with gout.[3]
Proactive Management Vs. Reactive Management:
Treating gout can be compared to how one would handle a fire. Waiting for a fire to start and then dousing it with water is comparable to treating a gout flare by only using pain management medications. This is a reactive approach. On the other hand, focusing on what “sparked the fire” and working with a healthcare professional to prevent those flames from igniting into future gout flares represents a proactive approach. The proactive method aims to keep those painful gout attacks from ever flaring up in the first place. Adding to this, recent studies—including one by TREND Community—utilized artificial intelligence (AI) technology to analyze online conversations from the Gout Support Group of America and a gout Reddit group. What they found was a connection between proactive management of gout and mental health benefits, shedding light on the importance of taking a preventative stance., [4, 5, 6]
Working With Healthcare Providers:
In the battle against gout, the doctor, especially a rheumatologist, is akin to serve as the coach in an important game. Rheumatologists are well versed in the tactics and strategies needed to keep pain at bay, and they act as a member of the team to help ensure victory by preventing future gout attacks and long-term damage and health consequences. This relationship is a partnership with a clear goal in mind: the complete elimination of gout flare-ups.[7]
The Gout Education Society developed a factsheet to help with initial questions to ask a doctor when visiting about gout.
Seek Support Groups:
No one is alone in his or her gout battle. Support groups, like the Gout Support Group of America, are there like a friendly huddle in a game—offering cheers, pointers and shared stories. It’s a team effort, with everyone rallying together—including those who’ve been through it before—to help each other move forward and overcome the challenges of gout.
End With Hope:
Living with gout does not have to equate to living life in pain. With proper care, guidance, and a proactive approach to managing gout, a quality, pain-free life is achievable. Whether kings or everyday people, understanding gout and taking a proactive stance can help those with gout rule their lives with more control and less pain. Maintaining a positive outlook, leaning on a qualified healthcare team, and keeping focused on managing gout effectively are all important factors. As my rheumatologist, Dr. Christopher Parker, says, “This is doable!”[8]
1. Seaver C. The strange history of gout, the King’s disease. History Defined. Updated January 29, 2023. Accessed August 25, 2023. https://www.historydefined.net/the-history-of-gout/?fbclid=IwAR0gJus0fRo3TzItBsXn8vZ40flkEtElcbfUrMYz6XEFzuwjOg71C3nRoBM#google_vignette
2. Donvito T. The 4 stages of gout progression (and how to stop gout from getting worse). CreakyJoints. October 25, 2019. Accessed August 25, 2023. https://creakyjoints.org/living-with-arthritis/treatment-and-care/medications/gout-stages-progression/
3. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Gout. National Institutes of Health. Updated February 2020. Accessed August 25, 2023. https://www.niams.nih.gov/health-topics/gout
4. Pine L. Gout flare, pain and primary motivators for seeking reactive care. HCPLive. June 1, 2023. Accessed August 25, 2023. https://www.hcplive.com/view/gout-flare-pain-are-primary-motivators-for-seeking-reactive-care
5. Flurie M, Coe J, Converse M, et al. Real-world evidence from social media provides insights into patient mental health outcomes in the management of gout. Presented at: ACR Convergence 2022; November 10-14, 2022; Philadelphia, PA. Abstract 0201.
6. Brody B. How AI is used to identify and address mental health in chronic illness community. CreakyJoints. November 8, 2022. Accessed August 25, 2023. https://creakyjoints.org/about-arthritis/gout/gout-symptoms/how-gout-patients-discuss-mental-health/
7. Dee JE. 5 reasons why a patient should see a rheumatologist. Yale School of Medicine. May 11, 2021. Accessed August 25, 2023. https://medicine.yale.edu/news-article/5-reasons-to-see-a-rheumatologist/
8. Talking gout and myths with Dr. Christopher Parker. HCPLive. May 29, 2020. Accessed August 25, 2023. https://www.hcplive.com/view/talking-gout-and-myths-dr-christopher-parker
