Gout at a Glance
Gout is a chronic, progressive form of arthritis. It most commonly appears in the big toe, causing joint swelling, sudden burning pain, and stiffness. Too much uric acid in the blood forms hard crystals which are deposited into joint tissue. Gout and the tendency to have high levels of uric acid in the blood can run in families. Although gout primarily affects men, women are more prone to develop gout after menopause. Let's look at what is gout and what are the symptoms, along with treatment options.
Causes and Symptoms
Gout is caused by too much uric acid in the blood, but many people have high levels of uric acid and never develop gout. Other causes of gout include obesity, heavy alcohol use, and a diet heavy in meats and seafood which are high in purines. Alcohol slows the removal of uric acid and should be avoided. Organ meats such as liver and kidneys are also high in purine and may aggravate development of kidney stones caused by uric acid. Another culprit is diuretics ("water" pills given to increase urine production). Other causes of increased uric acid levels include starvation diets, stress, strenuous exercise and fasting.
Gout often appears as a sudden nighttime attack of swelling, redness, sharp pain and tenderness in the big toe. Other areas susceptible to gout include the knees, ankles and feet. A gout attack may last for days or weeks, and can recurr weeks or even years later.
How Gout is Diagnosed
The best test for gout is taking a fluid sample from around the affected joint to look for uric acid crystals. The crystals can be seen on x-ray. Blood tests can also be done to monitor uric acid levels. Some drugs can alter uric acid levels in the blood. Diuretics can increase uric acid levels. At low levels, aspirin increases uric acid levels while high levels lower uric acid levels.
Treating gout is a two-step approach. First, prevention of acute inflammation of joints is vital. Second, long-term management requires minimizing the risk of future gout attacks and shrinking crystal deposits. One of the most common treatments for gout is corticosteroids such as prednisone to prevent inflammation. These drugs are designed for short-term use and may be taken orally or injected into the affected joint. Allopurinol lowers blood uric acid levels by preventing the production of uric acid. Probenecid and Anturane may be prescribed to increase the excretion of uric acid into the urine. Aspirin should not be taken by those with gout, since it prevents the kidneys from excreting uric acid. Patients who take anti-gout medications must have regular blood work done to monitor the uric acid levels of the blood.
Non-drug treatment for gout includes resting and elevating the inflamed joint and applying ice packs to relieve pain and reduce inflammation.Over-the-counter anti-inflammatory drugs such as ibuprofen may be taken. Diet options should focus on a healthy diet and avoid heavy intake of meat, seafood, and alcohol, especially beer. Low-fat dairy products may have a protective effect against gout and are a good source of protein. Adequate hydration with water is also important.
Gout is painful and progressive, but by learning how to manage symptoms, make dietary changes, and evaluate treatment options, gout sufferers can hopefully minimize pain and limit the effects of gout on everyday life.
Mayo Clinic: https://www.mayoclinic.com/health/gout/DS00090