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Portland Foot and Ankle

(503) 244-7894

Battle Ground Foot and Ankle

(360) 687-3668

Vancouver Foot and Ankle East

(360) 834-3707

Vancouver Foot and Ankle West

(360) 597-4223

What Is Gout?
Gout is a disorder that results from the build-up of uric acid in the tissues or a joint. It most often affects the joint of the big toe.

Causes
Gout attacks are caused by deposits of crystallized uric acid in the joint. Uric acid is present in the blood and eliminated in the urine, but in people who have gout, uric acid accumulates and crystallizes in the joints. Uric acid is the result of the breakdown of purines, chemicals that are found naturally in our bodies and in food. Some people develop gout because their kidneys have difficulty eliminating normal amounts of uric acid, while others produce too much uric acid.

Gout occurs most commonly in the big toe because uric acid is sensitive to temperature changes. At cooler temperatures, uric acid turns into crystals. Since the toe is the part of the body that is farthest from the heart, it’s also the coolest part of the body – and, thus, the most likely target of gout. However, gout can affect any joint in the body.

The tendency to accumulate uric acid is often inherited. Other factors that put a person at risk for developing gout include: high blood pressure, diabetes, obesity, surgery, chemotherapy, stress, and certain medications and vitamins. For example, the body’s ability to remove uric acid can be negatively affected by taking aspirin, some diuretic medications (“water pills”), and the vitamin niacin (also called nicotinic acid). While gout is more common in men aged 40 to 60 years, it can occur in younger men as well as in women.

Consuming foods and beverages that contain high levels of purines can trigger an attack of gout. Some foods contain more purines than others and have been associated with an increase of uric acid, which leads to gout. You may be able to reduce your chances of getting a gout attack by limiting or avoiding shellfish, organ meats (kidney, liver, etc.), red wine, beer, and red meat.

Symptoms
An attack of gout can be miserable, marked by the following symptoms:

  • Intense pain that comes on suddenly – often in the middle of the night or upon arising
  • Signs of inflammation such as redness, swelling, and warmth over the joint.

Diagnosis
To diagnose gout, the foot and ankle surgeon will ask questions about your personal and family medical history, followed by an examination of the affected joint. Laboratory tests and x-rays are sometimes ordered to determine if the inflammation is caused by something other than gout.

Treatment
Initial treatment of an attack of gout typically includes the following:

  • Medications. Prescription medications or injections are used to treat the pain, swelling, and inflammation.
  • Dietary restrictions. Foods and beverages that are high in purines should be avoided, since purines are converted in the body to uric acid.
  • Fluids. Drink plenty of water and other fluids each day, while also avoiding alcoholic beverages, which cause dehydration.
  • Immobilize and elevate the foot. Avoid standing and walking to give your foot a rest. Also, elevate your foot (level with or slightly above the heart) to help reduce swelling.

The symptoms of gout and the inflammatory process usually resolve in three to ten days with treatment. If gout symptoms continue despite the initial treatment, or if repeated attacks occur, see your primary care physician for maintenance treatment that may involve daily medication. In cases of repeated episodes, the underlying problem must be addressed, as the build-up of uric acid over time can cause arthritic damage to the joint.

Our Locations


Vancouver Foot and Ankle West


Vancouver Foot and Ankle East


Battle Ground Foot and Ankle


Portland Foot and Ankle


Hours of Operation

Vancouver Foot And Ankle West

Monday:

8:00 am-4:00 pm

Tuesday:

Closed

Wednesday:

Closed

Thursday:

8:00 am-4:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Vancouver Foot and Ankle East

Monday:

Closed

Tuesday:

Closed

Wednesday:

8:00 am-4:00 pm

Thursday:

8:00 am-4:00 pm

Friday:

8:00 am-4:00 pm

Saturday:

8:00 am-12:00pm (Alternating Saturday)

Sunday:

Closed

Battle Ground Foot and Ankle

Monday:

8:00 am-3:00 pm

(Alternating Monday)

Tuesday:

Closed

Wednesday:

8:00 am-4:00 pm

Thursday:

Closed

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Portland Foot and Ankle

Monday:

Closed

Tuesday:

8:00 am-3:00 pm

Wednesday:

Closed

Thursday:

Closed

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

  • "My 3rd and 4th toes on the right foot were so painful to walk for about 5 years or so. Dr Belnap clipped the tendons in the toes and clipped the nails of both feet on follow up appointments, and now I can walk without pain. I wish I had known of this procedure sooner and will surely recommend this office to friends!

    Side note: I know there has been discussion on getting access to all the x-rays from every location. Is that going to be possible in the future? It would be very helpful for surgical planning, as it is always a good idea to have a copy of the x-rays in the operating room for surgical planning purposes. The other solution I could think of is printing off the x-rays on surgical patients and scanning them into their charts as a document, so you can access them from anywhere.

    Thanks for all your help!!"
    Nancy P.
  • "Dr Belnap is very professional. He helped with my foot pain. He corrected my issues and I was pain-free by the first follow up visit!"
    Dennis B.
  • "I came to Dr Hayes from a personal referral. He has done surgery on both of my feet for bunions. It has helped me to live my busy lifestyle. I have highly recommended him to my friends"
    Susan N.