Gout

Gout

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. Gout can be acute (short-lasting) or chronic (long-lasting).

Symptoms of gout

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 of gout lasts 3 to 10 days on average. Chronic gout occurs more often, but may be less severe.

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 can trigger the attack.

How is gout diagnosed?

Your doctor will do a physical exam and review your symptoms and health history. Tell them if gout runs in your family. The doctor may detect gout by looking at your joints. To confirm a diagnosis, they will do a blood test or take a sample of fluid from your joint. These can check your uric acid level and look for uric acid crystals.

Can gout be prevented or avoided?

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

  • Limit or avoid foods that are rich in purines. These include salmon, sardines, herring, organ meats, asparagus, and mushrooms.
  • Try to eat foods that are low in salt and fat.
  • Lose weight, if you’re overweight.
  • 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, which is used to prevent the body from rejecting a new organ after transplant surgery.
  • Some drugs used to treat  cancer.
  • Pyrazinamide and ethambutol, which are used to treat tuberculosis.

Gout treatment

The sooner you start treatment, the sooner your 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 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 and naproxen. Your doctor can prescribe medicine for you. Examples include corticosteroids, like prednisone, or colchicine.

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 weeks.

Talk to your doctor if you continue to have gout attacks. The more frequent they are, the longer they can last and the more joints it can affect. Your doctor can prescribe medicines to help prevent future gout 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 doctor on a treatment plan to manage gout. You may need routine visits to check your uric acid level.

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

Questions to ask your doctor

  • Why do some people get gout and others don’t?
  • If I have a gout attack once, will I always have gout?
  • What medicine can I take to prevent future gout attacks?
  • If I have gout, am I at risk of other types of arthritis?
  • Am I at risk of long-term joint damage?