What is gout?

Gout is a health problem that causes inflamed, painful joints. The symptoms are caused by deposits of urate crystals at the joints. Gout used to be associated with kings who overindulged in rich food 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.

This condition is a form of inflammatory arthritis that results in painful attacks in the joints. It can cause swelling and redness, and in some cases, it can lead to lumpy deposits that can be seen under the skin. It can also lead to the development of kidney stones.

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. Too much 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. It may also 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:

• Alcoholic drinks and sugary drinks high in fructose

• Certain meats, such as game meats, kidney, brains, and liver

• Dried beans and dried peas

• Seafood, such as anchovies, herring, scallops, sardines, and mackerel

Gout attacks may be triggered by any of the following:

• Drinking alcohol

• Eating a lot of protein-rich foods

• Emotional stress

• Fatigue

• Illness

• Minor surgery

Who is at risk for gout?

You are at higher risk for gout if you:

• Are a man

• Are a postmenopausal woman

• 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:

• Chills

• Fever

• General feeling of illness

• Hard lumps of urate crystal deposits under the skin (tophi)

• Severe, sudden pain in one or more joints, most often the joint in the big toe

• Skin that is red or purple, tight, and shiny over the joint

• Swollen joint(s)

• Warmth in the joint area

Some symptoms of gout can be like other health conditions. Make sure to see your healthcare 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:

• Avoiding alcoholic drinks

• Colchicine, an oral or IV medicine to relieve pain and inflammation

• Corticosteroids to reduce inflammation

• Drinking more nonalcoholic fluids

• Eating less protein-rich foods

• Medicine to block production of uric acid in the body

• Medicine to lower the uric acid level in the blood

• Nonsteroidal anti-inflammatory medicines to relieve pain and inflammation

• Surgery to remove extremely large tophi

• Weight loss, if obesity is an issue

Talk with your healthcare provider about the risks, benefits, and possible side effects of all medicines.

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 medicine as prescribed. If you are given medicine to take when a flare-up occurs, it is best to start taking it at the first sign of symptoms. Or get medical attention at the first sign of symptoms. To help prevent episodes of gout:

• Talk with your healthcare provider before taking any new medicine, including over-the-counter medicines

• 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 healthcare provider know.

Key points about gout

• Gout causes 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 medicines and lifestyle changes.