Gout: Overview
Gout is a form of arthritis caused by a buildup of uric acid crystals in a joint. It causes sudden attacks of pain, swelling, redness, and stiffness, usually in one joint, especially the big toe.
Gout usually comes on without a cause. But it can be brought on by drinking alcohol (especially beer), eating or drinking things made with high-fructose corn syrup, or eating seafood or red meat. Taking certain medicines, such as diuretics, can also trigger an attack of gout.
Taking your medicines as prescribed and following up with your doctor regularly can help you avoid gout attacks in the future.
Gout
Gout is a form of arthritis caused by a buildup of uric acid crystals in a joint. It causes sudden attacks of pain, swelling, redness, and stiffness, usually in one joint. It happens most often in the big toe.
Gout usually comes on without a cause. But it can be brought on by drinking alcohol (especially beer), eating or drinking things made with high-fructose corn syrup, or eating seafood or red meat. Taking certain medicines, such as diuretics, can also trigger an attack of gout.
What happens when you have gout?
Gout develops from a buildup of uric acid crystals in the joints. It can cause a sudden attack of pain, stiffness, and swelling in a single joint, often a big toe. Another attack may not happen for months or years. If gout is not treated, the frequency of attacks usually increases.
What are the symptoms of gout?
The most common sign of gout is a nighttime attack of swelling, tenderness, redness, and intense pain in a joint, usually your big toe joint. It may get worse quickly and last for hours, a few days, or even weeks. Gout can affect how much you can move the affected the joint.
How is gout treated?
Medicines can help stop a gout attack and prevent future attacks. Resting the joint that hurts and taking anti-inflammatory medicine can also help you feel better.
Gout
Image courtesy of Paul Traughber, M.D., Boise, Idaho.
Figure 1 is an X-ray of a normal foot with healthy bones and joints.
Figure 2 is an X-ray of a deformed toe joint caused by long-term gout.
How are medicines used to treat gout?
Medicines are used to treat gout attacks and to reduce uric acid in the blood.
Both short-term and long-term medicines may be used.
- Short-term medicines.
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These relieve pain and reduce inflammation during an acute attack or prevent acute attacks from coming back.
They may include:
- NSAIDs.
- Colchicine.
- Corticosteroids.
- Long-term medicines.
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Medicines, such as allopurinol, lower uric acid levels in the blood. This can reduce how often you have gout attacks and how bad they are.
If your doctor prescribes medicine to lower uric acid levels, take it as directed. Most people will continue to take this medicine every day. Make sure you know how to take it.
- If you're taking one of these medicines, keep taking it during the attack.
- If you have one of these medicines but have not been taking it, don’t start taking it during the attack. It could make the attack worse. Ask your doctor before you take it.
How can you care for yourself when you have gout?
There are things you can do at home to help relieve gout symptoms. To reduce joint swelling, try using ice and propping up your sore limb. It may also help to avoid activities that put weight or strain on your sore joint.
Gouty Big Toe
Gout is caused by too much uric acid in the blood (hyperuricemia). Hyperuricemia usually does no harm. But sometimes when uric acid levels in the blood are too high, uric acid forms crystals that build up in the joints. The crystals can cause a gout attack. A gout attack typically causes pain, swelling, redness, and warmth (inflammation) in a single joint, most often the big toe.
What causes gout?
Gout is caused by too much uric acid in the blood (hyperuricemia). Most of the time, having too much uric acid isn't harmful. Many people with high levels in their blood never get gout. But sometimes when these levels in your blood are too high, the uric acid forms hard crystals in your joints. This causes pain and other symptoms.
In some cases, the exact cause isn't known. But inherited factors (genes) seem to play a role.
Gout can seem to flare up without specific cause. Or it can be brought on by:
- Being overweight, drinking too much alcohol, eating or drinking things made with high-fructose corn syrup, or eating seafood or red meat.
- Medicines, such as diuretics.
- Major illness or certain medical conditions, such as rapid weight loss or high blood pressure.
- Surgery.
- Having been born with a rare condition that causes high blood uric acid levels.
What is gout?
Gout is a form of arthritis. It usually occurs after years of buildup of uric acid crystals in the joints and surrounding tissues. Gout usually happens in one joint, often the big toe.
When you have gout, you may eventually have a gout attack. These attacks usually start at night, with sudden burning pain, stiffness, and swelling in a joint.
Gout: When to call
Call your doctor now or seek immediate medical care if:
- You have a fever.
- The joint is so painful you cannot use it.
- You have sudden, unexplained swelling, redness, warmth, or severe pain in one or more joints.
Watch closely for changes in your health, and be sure to contact your doctor if:
- You have joint pain.
- Your symptoms get worse or are not improving after 2 or 3 days.
What dietary changes can you make to help manage gout?
Medicines have largely replaced the need to restrict what you eat when you have gout. But making changes in your diet may still help.
To help control gout:
- Limit foods high in purines, especially meat, seafood, and beer.
- Avoid foods and drinks that are made with high-fructose corn syrup.
- Eat low-fat dairy products.
- Drink plenty of water. This can help your body get rid of uric acid.
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