What is gout?
Gout is a condition that causes inflamed, painful joints. The symptoms are caused by deposits of urate crystals at the joints. Gout used to be associated kings who overindulged in rich foods and wine. In truth, anyone can get gout. Gout affects more men than women. It is often linked with obesity, high blood pressure, high levels of lipids in the blood (hyperlipidemia), and diabetes.
What causes gout?
Gout is caused by monosodium urate crystal deposits in the joints. This is due to an excess of uric acid in the body. The excess of uric acid may be caused by several things. It may be caused by the body making too much uric acid. Or, the kidneys may not get rid of enough uric acid. And it may be caused by eating a lot of foods that are high in purines. Purines turn into uric acid in the body. Foods high in purines include certain meats, such as game meats, kidney, brains, and liver. It includes some seafood, such as anchovies, herring, scallops, sardines, and mackerel. And it includes dried beans and dried peas. Alcoholic drinks and sugary drinks high in fructose may also increase levels of uric acid in the body. Gout attacks may be triggered by any of the following:
- Drinking alcohol
- Eating a lot of protein-rich foods
- Emotional stress
- Minor surgery
Who is at risk for gout?
You are at higher risk for gout if you:
- Are a man
- Are a post-menopausal women
- Have kidney disease
- Have high blood pressure, high cholesterol, or diabetes
- Have family members with gout
What are the symptoms of gout?
Gout causes sudden, recurrent attacks of symptoms that often occur without warning. Severe, chronic gout may lead to deformity. Symptoms can occur a bit differently in each person. Common symptoms include:
- Severe, sudden pain in one or more joints, most often the joint in the big toe
- Swollen joint(s)
- Skin that is red or purple, tight, and shiny over the joint
- Warmth in the joint area
- General feeling of illness (malaise)
- Hard lumps of urate crystal deposits under the skin (tophi)
Some symptoms of gout can be like other health conditions. Make sure to see your health care provider for a diagnosis.
How is gout diagnosed?
The process starts with a medical history and a physical exam. A fluid sample may be taken from the joint and checked for urate crystals.
How is gout treated?
Treatment will depend on your symptoms, your age, and your general health. It will also depend on how severe the condition is. Treatment may include:
- Nonsteroidal anti-inflammatory medications to relieve pain and inflammation
- Corticosteroids to reduce inflammation
- Colchicine, an oral or IV medication to relieve pain and inflammation
- Drinking more non-alcoholic fluids
- Avoiding alcoholic drinks
- Eating less protein-rich foods
- Weight loss (if obesity is a factor)
- Medication to lower the uric acid level in the blood
- Medication to block production of uric acid in the body
- Surgery to remove extremely large tophi
Talk with your health care providers about the risks, benefits, and possible side effects of all medications.
What are the complications of gout?
People with gout have a higher risk for kidney stones, due to crystal deposits in the kidneys. They can also have kidney damage. Crystal deposits in the joints can cause some disability due to stiffness and pain.
Living with gout
You can reduce the risk of future flare-ups of gout and decrease their severity by taking medications as prescribed. If you are given medication to take when a flare-up occurs, it is best to start the medication at the first sign of symptoms. Or, get medical attention at the first sign of symptoms. To help prevent episodes of gout:
- Talk your health care provider before taking any new medications, including over-the-counter medications
- Drink plenty of water
- Don't drink alcohol
- Exercise regularly
- Lose weight if needed
- Don't eat foods that are high in purines
When should I call my health care provider?
If your symptoms get worse or you have new symptoms, let your health care provider know.
Key points about gout
- Gout caused inflamed, painful joints due to urate crystal deposits at the joints.
- Gout can also cause urate crystal deposits that cause lumps under the skin.
- Gout can be triggered by eating foods high in purines and drinking alcohol.
- Treatment of gout is aimed at reducing pain and the risk of future flare-ups.
- Gout can be managed with medications and lifestyle changes.
Tips to help you get the most from a visit to your health care provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
- Weisbart, Ed, MD
- Ziegler, Olivia Walton, MS, PA-C