Gout, the most common form of inflammatory arthritis, can wreak havoc on the body. The good news? It’s easily managed with the right help. Whether you’ve been recently diagnosed, care for someone suffering, or are a medical professional treating the disease, the Kicking Gout in the Acid podcast can help you learn more.
In this episode of Kicking Gout in the Acid, Dr. Larry Edwards is joined by Gout Education Society Board of Directors member Dr. Paul Doghramji, certified family practice physician at Collegeville Family Practice and physician advisor at Pottstown Memorial Medical Center in Pennsylvania. The two discuss the many misconceptions and myths about gout related to such topics as its prevalence, cause, treatment strategies and the role of diet and lifestyle modifications.
Key Takeaways:
Gout is more common than it’s often perceived – more than 12 million Americans are estimated to have the disease.
Gout myths are pervasive. Many people incorrectly believe gout is self-inflicted; in truth, gout is largely hereditary and not commonly brought on by poor diet and lifestyle choices.
Home remedies such as cherry juice are commonly seen as easy treatments for the disease; however, effective management includes anti-inflammatory medications and uric acid-lowering drugs.
Continual educational opportunities for both patients and medical professionals alike are key to breaking the many myths, misconceptions and stigma surrounding gout.
Start your journey with gout today via the Gout Education Society website and sign up for the monthly newsletter.
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Looking for nearby gout specialists? Find rheumatologists, nephrologists and more via the Gout Specialists Network.
Educational Materials:
Gout Patient Brochure
Medical Professional Guide
Kicking Gout in the Acid is sponsored by Sobi.
Podcast Transcript
Ian PonitzHello, and welcome to Kicking Gout In The Acid, a podcast from the Gout Education Society. My name is Ian Ponitz, and I'm your host for this series. Kicking Gout In The Acid features conversations between Dr. Larry Edwards, chairman and CEO of the Gout Education Society, and experts on the disease.
Each episode will dive into important topics that you, the listener, should know about gout. The goal? To feel empowered to get gout under control.
In this episode, Dr. Edwards will be joined by Dr. Paul Doghramji, certified family practice physician at Collegeville Family Practice and physician advisor at Pottstown Memorial Medical Center in Pennsylvania. The two will discuss common myths, misconceptions, and the stigma surrounding gout. We'll spend today's episode breaking down these notions in the hopes of improving education surrounding the disease. Dr. Edwards, take it from here.
Dr. Larry EdwardsThanks, Ian. We're joined today by one of the board members of the Gout Education Society, Dr. Paul Doghramji. Paul is a primary care physician in the Philadelphia area and has had a keen interest in gout for a while. Paul, let me have you introduce yourself.
Dr. Paul DoghramjiYes. Thank you, Larry. It's great to be here. Paul Doghramji. I am a family physician, board-certified in family practice, and I've been that way for a good many years. I got involved in the area of gout, oddly enough, in somewhat of a curved way. About 20-some years ago, my main area of interest was sleep disorders, and one of the things that I wrote about was restless leg syndrome. And then we did this huge national expose on the biology of leg disorders, so I wrote about restless leg syndrome, but at the same time, I also wrote about other things that can happen to legs, like gout.
So, I started writing about gout, and it opened a whole world of things that I got to know about when it came to gout and hyperuricemia. So, I did a lot of writing, and then after that, I still did a lot of education for my primary care providers, as well as the lay public on hyperuricemia and gout. And it's been wonderful to get all this information that I can share with primary care providers, be they MDs, DOs, nurse practitioners, physician assistants who do primary care, but also laypeople, about, again, the interesting things they need to know about gout, and also, as well, some of the misconceptions. So, it's been a really good journey, and I'm very pleased to be here to talk more about it.
Dr. Larry EdwardsWell, we're glad you're here, too, Paul. I'm glad that you picked up on gout as an area of interest. After all, family practitioners, primary care doctors, and deliverers are the people who see most of the gout. We're gonna start off today, really talking about myths and misconceptions.
Gout's a disease that's been around literally forever. There are inscriptions in the pyramids about gout. There was lots written in the ancient Greek and Roman medical literature about gout. And it's not surprising that a disease with that kind of history has picked up a lot of misconceptions and myths along the way. Unfortunately, a number of those can really change the way people look at gout as a disease, look at patients that have gout as potentially people who brought this disease on themselves.
I think it's an important part of education not just to talk about what really causes gout and all, but to dispel some of these misconceptions. What we're gonna do today is just run through some of the more common ones that we hear about all the time to get your take on them.
One is that gout is a relatively uncommon disease of minor consequence compared to the other kinda higher-priority diseases that follow gout around, such as high blood pressure and diabetes, kidney disease, heart disease. And so, the physicians might not have the time to address gout just because they're worried about these other things that are the close relatives of gout. What do you think about that, Paul?
Dr. Paul DoghramjiWell, first of all, interestingly, the last patient that I saw right before this recording was a gentleman who came in with knee pain, with a diffusion that most likely is from gout. I see gout quite often, and a lot of primary care providers do see it. I think the problem is that they don't actually identify it as being gout because gout eventually goes away. Like, within a couple of weeks, it goes away. And they attribute it to maybe a strain, a sprain, overuse, that sort of stuff.
So, it's a lot more than what you think, and a lot of gout actually goes unrecognized and undiagnosed. In regular practice, because we see men and women in their middle age and in their later years, especially those who have hereditary problems with gout, there's a lot of it there. You just have to have a high index of suspicion with patients presenting with acute joint pain, whether it's traumatic or not, that occurs predominantly in the peripheral joints, like the feet, the toes, the fingers, and the wrists, and occurs in a generally monoarticular way. So, it's a lot more than what we think it is.
Dr. Larry EdwardsYeah. Absolutely. And it is actually one of the most common forms of arthritis. We see a lot of advertisements on TV about psoriatic arthritis and rheumatoid arthritis, and various other things, but gout is much more common. In fact, it's as common as a lot of those other medical conditions you talked about, almost as common as diabetes. So, it's out there. This idea that it's just a minor concern, how would you address that?
Dr. Paul DoghramjiWell, it's not a minor concern. The first thing I think we should know is that statistics show that about 20% of adults have hyperuricemia, high uric acid levels. That's a lot of people. Only about maybe 10%, 20% of those people might get a gout attack, so we don't really understand in some ways the, you know, why some people get it and why some people don't. But it's a lot out there, and hyperuricemia is a bad thing. In many ways, we should think about it as too much blood pressure, too much sugar, too much cholesterol, where not only can it affect your joints, but it can also affect other areas.
You know, Larry, we're understanding that high uric acid can also be a risk factor for cardiovascular disease and renal disease. So, uric acid, in high amounts, can crystallize and cause damage and inflammation in many other organs of the body, not just joints.
Dr. Larry EdwardsAbsolutely. It's certainly not a minor condition, and it should be up at the top of the list of concerns, I think, when physicians see patients.
Dr. Paul DoghramjiAs far as the joint parts are concerned, in a lot of people who get gout attacks maybe once or twice a year or so, there's this misconception, if I just treat the gout attack, that's enough, because the rest of the time, they're fine. And what a lot of people don't understand is that in between these episodes, in these intercritical periods, uric acid is still damaging the joints, and as the months and years go by, it can increase the probability of developing degeneration of those joints and causing premature osteoarthritis.
So, not only is it damaging joints when they have a gout attack, but also in the intercritical periods, there are things going on. So, it's necessary not only to treat the gout attack, but also to do something about the uric acid so it doesn't damage the joints and possibly other parts of the body.
Dr. Larry EdwardsI think that's a good segue to one of our other common misconceptions about the disease, and that is that people think that when their joint is swollen and painful that they have gout, and when it's calmed down and there aren't any symptoms in the joint, they no longer have gout, not appreciating that this is a chronic disease that you will always have with you if you've had a gout flare in the past.
I think that leads to other problems, and I want to know if you see this: that patients come in and feel like if
