Gout is a type of inflammatory arthritis that causes sudden and severe attacks of pain, swelling, redness, and tenderness in one or more joints, most often the joint at the base of the big toe.
Here’s a detailed explanation of gout:
Causes of Gout
Gout occurs when urate crystals accumulate in your joints. Urate crystals form when you have high levels of uric acid in your blood (hyperuricemia). Your body produces uric acid when it breaks down purines, substances found naturally in your body and in certain foods. Normally, your kidneys filter uric acid out of your blood, and it leaves your body in your urine. But if your body makes too much uric acid or your kidneys don’t remove it effectively, uric acid levels can rise. When this happens, urate crystals can form and deposit in your joints, causing inflammation and the sudden, severe pain of a gout attack.
Several factors can increase your risk of gout, including:
- Diet: Certain foods and beverages are high in purines, which can increase uric acid levels in your blood. These include red meat, organ meats (such as liver and kidney), seafood (especially shellfish), alcoholic beverages (especially beer), and drinks sweetened with fructose.
- Weight: People who are overweight or obese are more likely to develop gout.
- Medical conditions: Certain medical conditions can increase your risk of gout, such as high blood pressure, diabetes, and kidney disease.
- Medications: Some medications can increase uric acid levels or interfere with your kidneys’ ability to remove uric acid from your blood. These include diuretics (water pills), low-dose aspirin, and cyclosporine.
- Genetics: A family history of gout increases your risk of developing the condition.
- Sudden changes in uric acid levels: Sudden changes in your uric acid levels, either an increase or decrease, can trigger a gout attack. This can occur due to illness, surgery, starting or stopping certain medications, or dehydration.
Symptoms of Gout
Gout attacks typically come on suddenly, often in the middle of the night. The most common symptom of gout is intense joint pain. Other symptoms of a gout attack can include:
- Swelling in the affected joint
- Redness of the affected joint
- Tenderness to the touch
- Warmth in the affected joint
- Limited range of motion in the affected joint The joint at the base of the big toe is the most commonly affected joint in gout attacks. However, gout can affect any joint in your body, including your ankles, knees, elbows, wrists, and fingers.
Diagnosis of Gout
Several tests can help diagnose gout, including:
- Joint fluid aspiration: A needle is inserted into the affected joint to remove a sample of fluid. The fluid is then examined under a microscope to look for urate crystals.
- Blood tests: Blood tests can measure your uric acid levels. However, not everyone with high uric acid levels will develop gout.
- Imaging tests: X-rays, ultrasounds, or CT scans may be used to look for damage to the joint caused by gout or to rule out other possible causes of your symptoms.
Treatment of Gout
The main goals of gout treatment are to relieve pain and inflammation during a gout attack and to prevent future attacks.
- Medications to relieve pain and inflammation: During a gout attack, medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or colchicine may be used to reduce pain and inflammation.
- Medications to lower uric acid levels: Medications such as allopurinol, febuxostat, or lesinurad can help lower uric acid levels in your blood and prevent future gout attacks.
- Lifestyle changes: Making lifestyle changes can help lower your uric acid levels and reduce your risk of future gout attacks. These changes may include:
- Eating a healthy diet that is low in purines
- Maintaining a healthy weight
- Drinking plenty of fluids
- Limiting alcohol consumption
- Exercising regularly
If you think you might have gout, it’s important to see your doctor for diagnosis and treatment. Early diagnosis and treatment can help prevent future gout attacks and joint damage.