The condition of gout results from an inborn error of purine metabolism.  Purine is a compound found in high-protein foods, the metabolism of which produces uric acid.  It is a form of arthritis which is often hereditary.  After several years of acute attacks, the chronic form of the condition may set in, permanently damaging and deforming joints, and destroying cells of the kidneys.  About 95% of all cases occur in men.  It may be present during adolescence but the peak incidence is after age 40.  Gouty arthritis involves mainly the peripheral joints of the feet and hands, by far the most common site being the big toe.  For reasons not yet understood, the uric acid normally expelled in the urine, is retained in the blood in excess amounts,  It accumulates in the joints and cartilage, where it crystallized, forming lumps.  this leads to inflammation, swelling and stiff, tight joints.

An acute attack of gout can be treated successfully with several medicines, but remember that this is simply treatment of the acutely painful symptoms - and with every pain relieving, anti-inflammatory drug, you are at risk of damage to your liver, kidneys, gastro-intestinal tract.

The initial attacks may leave no joint deterioration after their passing, but after several acute attacks, chronic gout may develop.  The joints affected by chronic gout degenerate in the same way as joints affected by rheumatoid arthritis, eventually becoming very painful and losing their ability to move.  In 10% to 20% of people with chronic gout, damage to the renal tubules (parts of the kidneys) occurs as the result of the formation of kidney stones.

A variety of general factors, including infection, alcoholic or dietary indiscretion, and emotional stress factors, as well as injury and exposure to cold can precipitate acute attacks.  If acute gout is recognized at an early stage and treated correctly, the development of the chronic form can generally be prevented.

If you are susceptible to this condition, this means you must remain conscious of the foods to take in to your precious body.  Considering the tremendous variety of succulent foods available, this need not be a burden.  It can be a new, and luscious, game.  Also, be cautious of diuretics (any agent that promotes urine excretion) because this can increase the removal of fluid without taking the uric acid with it.  Some prescription drugs are diuretic, as are some common substances such as tea, coffee, and alcohol.  The following foods are especially high in purine:  kidney, liver, sweetbreads, sardines, anchovies, meat extract.  A purine-free diet consists of omitting meat, poultry and fish -- but using eggs, cheese, vegetables, grains and fruits.  Keep in mind that all meat protein contains purine.

Therapeutic massage can relieve this condition during an episode by assisting the flow of blood and lymph (a fluid that bathes the cells with nutrients an flushes away metabolic wastes).  Skillful manipulation of the soft tissue around the joints increases their range of movement by making the tendinous connective tissue more pliable, relaxing the muscles controlling the movement of the joint, soothing the nerves and helping to bring the body back into balance.  Pain and swelling are relieved as the congestion is reduced/removed from the joints.

After an acute episode, to prevent a recurrence:

    -    be mindful of the foods and beverages you consume and any medications you are taking

    -    drink as much pure water as is comfortable daily

    -    have therapeutic massage specific to this condition as often as you can (at least once per month)

    -    maintain a light exercise program to keep the joints functioning, the blood and lymph circulating    

         and the muscles evenly toned.

Sources:  Encyclopedia and Dictionary of Medicine, Nursing and Allied Health, by Miller-Keane,  Textbook of Disorders and Injuries of the Musculoskeletal System, by Robert B. Salter.