The Rich Man's Disease: The Arthritic Condition Still Left in the Dark

Well, this may seem like a strange topic, and granted it is. However, recently a friend of mine and I were discussing family. He brought up the fact that his brother-in-law had disclosed to him that he had "Rich Man's Disease." Seemingly as curious as I he asked what that was, an illness in which joint pain ensues in the legs and feet upon eating meats like beef and fish. This set me off on a hunt for the truth. I don't eat a lot of beef, in fact I almost never do and my doctor is not happy about it. However, I eat more sushi than anyone actually has business eating, so I was curious about the onset and triggers behind this mysterious "Rich Man's Disease." To my surprise, after a thorough amount of research, our mysterious "Rich Man's Disease" is no other than Gout.

Yes, you have probably heard of "The Gout" before, and probably not in the best of circumstances either. As for myself, I'd only ever heard of it in movies that take place way back in "the day." It's true that Gout is an ancient illness, but it is also true that its still a problem today, have a look on the internet, there is information everywhere! Not only that, but Gout actually affects over 2 million Americans a year and is responsible for about 5% of all arthritis cases in the U.S. (Gout Introduction, 2006). Shocking? Perhaps you'd like to know more?

First you should know exactly what Gout is. Gout is a form of arthritis, an chronic form of inflammatory arthritis that causes intense and painful swelling in the joints, most often the feet, especially the big toe, but can also affect the legs as well of other major joint areas. (American College of Rheumatology, 2006). Gout is characterized by intense and very severe attacks of pain, redness, and tenderness in one's joints. (Mayo Clinic Staff, 2005). The good news about this lesser known form of arthritis is that there is treatment available, and we'll discuss that as soon as we discuss who exactly gets Gout and how.

The particular question of who gets Gout and how was something that really perplexed me, especially with the news that a friend's relative had been diagnosed with it. Well, according the American College of Rheumatology Gout affects as 6-7% of older men, but also occurs often in women after menopause, and people with kidney disease. (American College of Rheumatology, 2006). Still the numbers at this point suggest a significantly higher count of men with the condition, a stunning 95% of Gout sufferers are men. (Gout Introduction, 2006). This condition, sometimes called "Rich Man's Disease" occurs due to an accumulation of urate crystals in the joints and tissues causing the characteristic pain and swelling. Everyone has uric acid in their bodies, it's a waste product produced in the breakdown of certain "rich" foods such as seafood, beans, excessive amounts of red meat, gravies etc... Hence the nickname "Rich Man's Disease." (The condition used to be suffered mostly by kings and lords of old due to their inactivity and diets rich in meats and wines.) High levels of uric acid, found in purines from rich foods, accumulates in the body, due to the body's production of too much uric acid or excreting too little. That acculumation causes the excess uric acid to build up near the joints and crystallize. (Mayo Clinic Staff, 2005). However, that isn't the only way to get Gout, in fact, Gout can also result from surgery, stress, crash diets, sudden severe illness, chemotherapy, joint injury, high blood pressure, and excessive exercise. (DePuy Orthopaedics, 2007). So in reality, Gout isn't just a rich man's disease, but a condition everyone is susceptible to under certain conditions. Gout brought about due to medical procedures or medication is called secondary gout. However, 99% of gout is brought about through other means. (Gout Introduction, 2006).

Too bad joint pain isn't the only result of Gout. Unfortunately, there are a number of other complications, so Gout can and is a very serious form of arthritis. The condition is often associated with heart and kidney disease.

Still, the main problems are lumps that build up in the joints and under the skin, sometimes coming through the skin as a while nodule. These sorts of lumps will be something the doctor will look for upon a physical examination. Other tests, such as the testing of joint fluid for uric acid crystals would also be conducted when testing for Gout. If you are diagnosed with Gout, your doctor will be able to work closely with you to reduce the number of gout attacks, and to reduce the size and number of uric acid crystal buildups in your joints. (American College of Rheumatology, 2006).

Each case and patient are different, so treatments are personalized on a case by case basis. Generally drugs are given to control the initial inflammation, and although these drugs have shown great results, "75% of patients show major improvements in symptoms with in 12 hours of ingesting the medications (NSAIDs)" (Gout Introduction, 2006), however there are some major gastrointestinal side effects. Patients with acute cases will also rely on uric acid controlling medication on a regular basis. However, clearly lifestyle changes will be necessary to keep Gout symptoms in check.

Seemingly the best self treatment is a diet planned with the help of a dietitian or doctor that is low in the kind of purine rich foods that exacerbate the problem. Gradual weight loss and alcohol avoidance are also highly recommended for qualifying individuals by the American College of Rheumatology.

In general, the Mayo Clinic reports no specific way to prevent gout. However, they do suggest keeping uric acid within a normal range is a long-term key. (2005). For you, that means limiting high purine foods such as alcohol, anchovies, sardines, liver, beef kidneys, brains, herring, mackerel, scallops, game meats, and gravy. Use all meats in moderation, as well as oatmeal, wheat bran and wheat germ, lentils and other dried beans, cauliflower, spinach, asparagus, mushrooms, and green peas. (Tsang, 2005).

Although you don't have to change your diet dramatically if you haven't been diagnosed with Gout, but it is best to try and watch your diet. If you're used to eating the aforementioned foods on a regular basis, shake up or menu and try to incorporate other foods. By just adding a little variety and keeping your heath and weight in mind, you're more likely to avoid this seemingly publicly unknown condition.

References:

N.A (2006). Gout Introduction. Retrieved March 15, 2007, from Supplement News Website: http://www.supplementnews.org/gout/

American College of Rheumatology. (2006). Gout. Retrieved March 16, 2007, from American College of Rheumatology Website: http://www.rheumatology.org/public/factsheets/gout_new.asp

Mayo Clinic Staff. (2005). Gout. Retrieved March 16, 2007, from Mayo Clinic Website: http://www.mayoclinic.com/health/gout/DS00090

DePuy Orthopaedics. (2007). What is Gout? Retrieved March 16, 2007, from All About Arthritis Website: http://www.allaboutarthritis.com/AllAboutArthritis/layoutTemplates/html/en/contentdisplay/document.jsp;jsessionid=5KVIOG0XDOZJOCQPCB3SVRYKB2II0NSC?docID=condition/arthritis/clinicalArticle/gout_what_is_it.xml

Tsang, G. RD. (2005). Gout Diet/Low Purine Diet: Limit High Purine Foods. Retrieved March 16, 2007, from Health Castle Website: http://www.healthcastle.com/gout.shtml