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When uric acid attacks MORE ABOUT GOUT
Historically called 'the disease of kings,' painful gout can afflict anyone

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Date published: 3/29/2009


One morning four years ago, Stafford County resident Rick Pantaleo woke up and realized that something was wrong with his right foot.

"It had swollen with a bit of pain, but what I noticed was how difficult it was to walk on," Pantaleo said.

He didn't think it could be anything more serious than a plantar wart, but he visited a podiatrist the next day to get it checked out.

Nothing showed up on an X-ray, and the doctor wrapped the foot in gauze and prescribed painkillers. This worked at first, but the condition quickly became more severe.

Pantaleo's foot became swollen, inflamed and too tender to put the slightest pressure on.

"I missed work since I was unable to walk the short distance from the train station to work," he said. "The pain from an attack was so severe that it would literally bring tears to my eyes."

He said he had trouble concentrating "or doing anything remotely normal."

"I felt like an invalid," Pantaleo said.

He went back to his podiatrist, who sent him to see a rheumatologist, a doctor who specializes in arthritis and other conditions of the joints, bones and muscles.

It was there that Pantaleo was diagnosed with gout.


According to the Mayo Clinic, gout is "a form of arthritis that's characterized by sudden, severe attacks of pain, redness and tenderness in joints."

This complex disorder is caused when urate crystals accumulate around the joints because there is an imbalance of uric acid in the body. It can be caused by the consumption of too many foods high in purines, such as seafood, organ meat and alcohol.

Gout most commonly affects men between the ages of 30 and 55 and women after menopause, said Dr. Avnit Ahuja of Rheumatology Associates of Central Virginia. She said all 10 gout patients she had seen so far this month were male.

"It's a very painful condition; your foot feels like it's on fire," Ahuja said. "People with gout can't go to work, have trouble walking and even getting up to go to the bathroom."


Rheumatology practices in the Fredericksburg area are quite busy, and patients in general can face waits to get an appointment.

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Since gout can be triggered by eating rich foods and wine, it's been called "the disease of kings." Alexander the Great, Charlemagne, Henry VIII and Louis XIV all were sufferers. Today, anyone who can afford to dine out once in a while is susceptible to the disease.

During the 16th and 17th centuries, aristocrats suffering from the condition would confine themselves to a sofa called a "gout couch."

Animals never get gout since they have an extra enzyme that breaks down uric acid one step further than in humans, according to local foot specialist Dr. Michael Donato. A uric acid imbalance causes gout.

Cherries, sometimes used as treatment, may appear to ease gout because they are rich in vitamin C, but they are not a reliable treatment, said Dr. Avnit Ahuja, a Fredericksburg rheumatologist.


Extreme pain, swelling, tenderness and warmth, most commonly in the big toe, but also in the feet, ankles or knees

Pain that starts during the night and is so intense that even light pressure from a sheet is unbearable

A rapid increase in discomfort, which lasts for several hours and then eases during the next few days

Peeling, itchy skin around the affected joint as the gout attack subsides

Very red or purplish skin around the affected joint, which may appear to be infected


Limited ability to move the affected joint.