Gout is a common form of inflammatory arthritis that is very painful. It usually affects one joint at a time (often the big toe joint). There are times when symptoms get worse, known as flares, and times when there are no symptoms, known as remission. Repeated bouts of gout can lead to gouty arthritis, a worsening form of arthritis.
There is no cure for gout, but you can effectively treat and manage the condition with medication and self-management strategies.
What are the signs and symptoms of gout?
Gout flares start suddenly and can last days or weeks. These flares are followed by long periods of remission—weeks, months, or years—without symptoms before another flare begins. Gout usually occurs in only one joint at a time. It is often found in the big toe. Along with the big toe, joints that are commonly affected are the lesser toe joints, the ankle, and the knee.
Symptoms in the affected joint(s) may include:
Pain, usually intense
Swelling
Redness
Heat
What causes gout?
Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat. When there is too much uric acid in the body, uric acid crystals (monosodium urate) can build up in joints, fluids, and tissues within the body. Hyperuricemia does not always cause gout, and hyperuricemia without gout symptoms does not need to be treated.
What increases your chances for gout?
The following make it more likely that you will develop hyperuricemia, which causes gout:
Being male
Being obese
Having certain health conditions, including:
Congestive heart failure
Hypertension (high blood pressure)
Insulin resistance
Metabolic syndrome
Diabetes
Poor kidney function
Using certain medications, such as diuretics (water pills).
Drinking alcohol. The risk of gout is greater as alcohol intake goes up.
Eating or drinking food and drinks high in fructose (a type of sugar).
Having a diet high in purines, which the body breaks down into uric acid. Purine-rich foods include red meat, organ meat, and some kinds of seafood, such as anchovies, sardines, mussels, scallops, trout, and tuna.
How is gout diagnosed?
A medical doctor diagnoses gout by assessing your symptoms and the results of your physical examination, X-rays, and lab tests. Gout can only be diagnosed during a flare when a joint is hot, swollen, and painful and when a lab test finds uric acid crystals in the affected joint.
How is gout treated?
Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to
Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
Prevent future flares. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food (like red meat or organ meat), may help prevent future attacks. Changing or stopping medications associated with hyperuricemia (like diuretics) may also help.
Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.
In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.
Summary
Gout is a common form of arthritis that affects the joints. It can lead to intense pain, swelling, and stiffness. The condition affects more than 3 million Americans and is more prevalent in males than females.
Hyperuricemia — when too much uric acid is present in a person’s blood — is the leading cause of gout.
Individuals may experience hyperuricemia if their body overproduces uric acid or if their kidneys do not excrete the substance adequately.
A doctor will typically recommend prescription medications to treat gout. This may include treatments to reduce inflammation in the affected joints and drugs to help regulate uric acid levels.
People can help reduce their risk of developing gout by avoiding foods high in purines that the body converts into uric acid, keeping adequately hydrated, and avoiding alcohol.
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