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OVERVIEW

What is gout?

Gout is a common type of arthritis.  It is marked by swelling and pain in your joints. It most often occurs in one or both of your big toes. It can affect your feet, ankles, fingers, wrists, elbows, and knees as well. Men develop gout more often than women. Women are more likely to develop gout after menopause. The condition can be acute (short-lasting) or chronic (long-lasting). It can be extremely painful.

SYMPTOMS

The symptoms of gout may be sudden and often start at night. The affected joint swells and becomes red, hot, and painful. The joint may become stiff and hurt more when you touch it. An acute attack lasts 3 to 10 days on average, and nearly all resolve within 2 weeks. Chronic cases occur more often but may be less severe.

CAUSES

What causes gout?

Too much uric acid in your body causes gout. Uric acid forms naturally when your body breaks down purines. Purines also are found in some foods we eat. Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. In people who have gout, uric acid builds up and forms sharp crystals in the joint space. Gout is genetic and can run in families. Stress, poor diet, alcohol use, and other health problems, such as diabetes, congestive heart failure, and hypertension can trigger the attack.

DIAGNOSIS

Your healthcare provider may do a physical exam and review your symptoms and health history. Tell them if gout runs in your family. Your healthcare provider may detect the condition by looking at your joints. To confirm a diagnosis, they can take a sample of the fluid from your joint and look for uric acid crystals. A blood test can check for elevated uric acid in your blood but doesn’t always confirm if you currently have a gout attack.

PREVENTION

There are several ways you can help lower your risk of gout and prevent future attacks.

• Avoid foods that are high in purines. These include salmon, sardines, organ meats, red meats, asparagus, mushrooms, and herring.
• Try to eat foods that are low in sugar, salt, and fat.
• Lose weight if you’re overweight.
• Avoid alcohol or limit the amount of alcohol you drink.
• Drink lots of water to help flush uric acid from your body.

Certain health conditions can increase your chance of gout. Get treatment if you have high cholesterol, high blood pressure, or diabetes. Medicines that may cause gout include:

• Diuretics (“water pills”) used to treat high blood pressure
• Niacin (a B-complex vitamin)
• Aspirin (taken in low doses)
• Cyclosporine (used to prevent the body from rejecting a new organ after transplant surgery)
• Some drugs used to treat cancer
• Pyrazinamide and ethambutol (used to treat tuberculosis)

TREATMENT

The sooner you get treatment, the sooner the pain will go away.  There are several things you can do to treat symptoms.

• Limit the amount of animal protein you eat.
• Avoid alcohol completely.
• Drink extra water to flush your body of uric acid.
• Limit use of your affected joint and rest in bed.
• Keep clothes and bedding off the joint to avoid irritation.
• Elevate your joint to help reduce swelling.
• Take medicine to reduce swelling and relieve pain. Over-the-counter medicines include ibuprofen (some brands: Motrin, Advil) and naproxen (one brand: Aleve). Your healthcare provider can also prescribe medicine for you. Examples include corticosteroids, like prednisone, or colchicine.
• Talk to your healthcare provider about prescription medicine, such as allopurinol, febuxostat, and pegloticase.

Living with gout

With the proper treatment, your gout attack should go away in a few days.  If left untreated, it can last for several days or up to 2 weeks.

Contact your healthcare provider if you continue to have attacks.  The more frequent they are, the longer they can last and the more joints it can affect. Your healthcare provider can prescribe medicines to help prevent future attacks. These medicines wash the uric acid from your joints, lower the level in your body, and reduce swelling. Aspirin can interfere with the way these medicines work. Work with your healthcare provider on a treatment plan to manage the condition. You may need routine visits to check your uric acid level.

Over time, gout attacks may lead to tophi . These are uric acid crystals that form lumps under the skin. Tophi usually form on the toes, fingers, hands and elbows. They cause chronic pain and can destroy the bones around your joints. You may also develop kidney disease or kidney stones from uric acid crystals that collect in the urinary tract.