THE HEART OF THE MATTER
a special program of the National Emergency Medicine Association (NEMA) 

Week: 522.3 Guest: Howard Hauptmann, M.D. Topic: Gout...The Preventable Arthritis Host: Steve Girard Producer: Ed Graham

NEMA: Watching my dad suffer through bouts with gout still gets to me today...him with his knee swollen like a bowling ball, in extreme pain, and me trying to figure out how to help him feel better. Well, today, gout is no longer called the great crippler, or rich man's disease...it's really the most preventable and treatable type of arthritis. We're with Dr. Howard Hauptmann...a rheumatologist who sees people with gout every day....

Hauptmann: Gout is a form of arthritis that shows itself in several different ways...the most common way is an acute, sudden onset of joint pain, that is so excruciating, to some extent you can't even put your bedclothes on.

NEMA: What brings on these attacks?

Hauptmann: Its cause by an over excess of a substance in our body called uric acid. And there are many ways to over accumulate uric acid, which then can lead to gout. Also there are ways of preventing it, if someone knows what to do about it.

NEMA: How do we develop this uric acid?

Hauptmann: Uric acid is found in everybody. What happens sometimes in certain conditions is that it will precipitate and lodge in joints and its when it lodges in these joints that we react to it, causing marked, very painful reactions that make the joint swell, become red, hot...and painful.

NEMA: And if someone feels the pains they're having may be gout?....

Hauptmann: The best thing is to be evaluated, to really find out whether that is the type of arthritis you have, or is there some other explanation to the pain your having. The other thing about gout is because uric acid is in everybody but only certain people are predisposed to it...is to find out what may be causing gout in you, because its quite preventable. You had mentioned alcohol and rich foods, and all these things, along with certain drugs, can build up an overabundance of uric acid and then cause an attack...sort of the old adage, he who plays, pays....a little too much alcohol you may pay the price for it. While other people, who may not be predisposed, may have no problems with the same sort of drugs or lifestyle changes

NEMA: What type of medications can help prevent gout attacks.....?

Hauptmann: Over many years, its possible that you can build up excess uric acid in the tissues...and in that case, you really want to take certain medications that would lower the total amount of uric acid in the body. There are several drugs, one is called alopurinol or zyloprim, or another drug called probenicid that actually lower the amount of uric acid, and if you're having episodes that start becoming repetitive, you really want to lower the uric acid in your body.

NEMA: Gout can start out in a joint feeling hot, looking red...but over time, and without treatment, it can get worse. If you feel you have a genetic possibility for this type of arthritis, or have a diet that may lend itself to gout...think about it - give it the attention it deserves...see your doctor. For more information on gout, and other forms of arthritis, call the Arthritis Foundation at 800-283-7800. I'm SG.