What is gout?
Gout is characterized by swollen joints that flare up, lasting a week or so, followed by lingering pain and discomfort. A chemical called serum urate (or uric acid) builds up in the body, forming sharp crystals in and around the joint and leading to inflammation and arthritis of the joint. Gout typically begins in your lower joints, such as your big toes.
While the pain of gout comes as attacks, the lead-up comes in stages. The asymptomatic hyperuricemia period is when the uric acid causes painful crystals to form. Gout attacks are often caused by a spike in uric acid levels. Intervals between gout attacks mark a period of discomfort where the joints are still inflamed. If gout lasts for a long time, it’s considered chronic, due to increased levels of uric acid.
The primary symptoms of gout are similar to other arthritic diseases:
- Intense pain
- Redness and warmth of the skin
Gout attacks occur suddenly and can last from days to weeks, but are interspersed with periods of remission that can last as long as a few years. When attacks occur, gout usually only affects one joint at a time.
Gout is caused by excessive uric acid in your bloodstream. This in itself isn’t harmful, and most people with high levels of uric acid don’t develop gout. However, sometimes crystals form on the joints and cause gout.
Specific triggers for gout flare-ups aren’t known, aside from genetic factors. Some other causes include:
- Taking certain medicines like diuretics and aspirin
- Eating meat high in purines (like venison, turkey, or bacon)
- Drinking lots of alcohol
Who can get gout?
While gout can affect anyone, it typically appears sooner in men than in women. After menopause, women experience it more often. This trend is because men retain higher levels of uric acid during their lives.
People with certain pre-existing conditions are more likely to develop gout. Examples include:
Diagnosis and tests for gout
Gout and other forms of arthritis can mimic each other. Determining the presence of uric acid crystals is key to a diagnosis. Even though uric acid is the culprit for gout, testing uric acid levels through blood tests can be misleading, since many people with high uric acid levels don’t develop gout.
Gout attacks typically start at night with sharp pains caused by the uric acid crystals. If you think you have gout, a visit to the doctor can help you know for sure. The doctor will try to locate the crystals to diagnose gout by extracting fluid from the joint. Analysis of the fluid reveals the presence of uric acid crystals.
Initial tests for gout involve patterns of joint use, checking for other characteristic symptoms, and examining a timetable for your pain. For chronic and long-term joint pain, X-rays and ultrasounds can show damage to the joints.
Treatment for gout
Gout treatment and diagnosis should be reserved for a rheumatologist since the signs of gout aren’t clear. Many quick gout treatments aim to relieve pain and inflammation during an attack. Long-term relief requires long-term treatments.
Most drugs to treat gout are intended to relieve inflammation and lower uric acid levels. Some of the drugs you may need to take to treat gout are:
- Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs)
- Uricosuric agents
- Xanthine oxidase inhibitors
One of the most important means of treating gout is through everyday lifestyle changes. Some things you can do include:
- Use cold packs and ice applied to the inflamed joint to reduce inflammation.
- Rest the joint until the pain subsides.
To prevent future flare-ups, make changes to your diet. Doing so will also reduce uric acid levels. You can:
- Reduce consumption of meat and shellfish.
- Reduce intake of alcohol.
- Cut back on food and drinks containing high-fructose corn syrup.
- Drink plenty of water.
If standard methods for treating gout aren’t working, a few other methods might help:
- Drink coffee! Coffee-drinking lowers your uric acid level and can prevent future flare-ups.
- Take vitamin C. It can reduce uric acid (but hasn’t demonstrated a direct link to reducing the frequency of gout attacks).
- Cherries have lower uric acid levels and reduce the frequency of gout attacks. So, eating cherries or drinking cherry extract could be a safe pairing with other gout treatments.
Complications of gout
Chronic gout can cause long-term damage to the affected joints if not treated. Additionally, gout can be related to other health issues that should be considered if gout persists. This includes:
If not treated, gout can develop severe conditions:
- Urate crystals can form under the skin as nodules (called tophi) around your body. They typically aren’t painful but can become swollen during gout attacks.
- Urate crystals can form in the urinary tract, which can lead to kidney stones.
American College of Rheumatology: "Gout."
American Journal of Clinical Nutrition: "Coffee consumption and risk of incident gout in women: the Nurses' Health Study."
American Kidney Fund: "Who is at risk for gout?"
Centers for Disease Control and Prevention: "Gout."
Dr. Axe: "6 Gout Remedies that Work."
Harvard Health Publishing: "A new-old way to treat gout."
National Health Service: "Gout."
National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Gout."
Stanford Health Care: "Gout Causes."
UPMC Pinnacle: "What Is Gout?: Know the Signs and Risk Factors."
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