Gout-Causes, Symptoms, Diagnoses, Causes, Prevention

What Is Gout?

Gout is a complex form of arthritis, which results from the buildup of uric acid in the body. It causes sudden pain, swelling, and redness in the joints, most commonly the big toe. You might feel like your big toe is on fire, suddenly in the middle of the night. Gout causes bouts of severe pain and tenderness in your joints. It commonly affects men, and it affects woman usually after menopause.

Quick Facts

• Gout is a type of arthritis.

• Pain and inflammation of the joint results due to uric acid crystal formation in them.

• Burning pain in the big toe is characteristic of gout.

• Medications can treat most cases of gout.

What Causes Gout?

Hyperuricemia (excess uric acid in the blood) causes gout. Uric acid is produced when purines, which are naturally found in the body and food like seafood and organ meats, breakdown. Usually, the uric acid that is produced, gets excreted through the urine.

But if the body produces too much uric acid or the kidneys are not able to efficiently excrete it, then excess uric acid builds up in the body. The excess uric acid form urate crystals, which get accumulated in the joints. These urate crystals result in inflammation and intense joint pain.

Eating too much of foods like shellfish, red meat, sweet juices, and salt can also result in gout. Kidney problems, thyroid diseases, and medications (diuretics and Cyclosporine) can affect the body’s ability to eliminate uric acid.

What Are the Symptoms of Gout?

Patients usually experience sudden and intense pain, mostly in the night. The symptoms are:

• Severe joint pain, most commonly the big toe. The other joints that can get affected are knee, ankles, elbows, and fingers.

• The pain is severe for the first 4 to 12 hours. After which, the pain subsides and can last for days to weeks.

• The joints appear red and become inflamed.

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• The joints range of motion decreases.

What Are the Stages of Gout?

The four stages of gout are:

1. Asymptomatic hyperuricemia - This stage is when the uric acid in the blood is high, but no other symptoms are seen.

2. Acute gout - In this stage, the high uric acid results in the formation of uric acid crystals in one joint. This causes pain, swelling, and tenderness in the affected joint. The pain will develop suddenly and last for 3 to 10 days. A person may have multiple such attacks over months or years.

3. Interval gout - Otherwise called intercritical gout, is the time between two attacks of acute gout.

4. Chronic tophaceous gout - If gout is left untreated for many years, hard nodules (tophi) form in the joints and surrounding tissue. This permanently damages your joints.

What Are the Risk Factors for Gout?

• Some of the factors that increase the risk of gout are:

• Postmenopausal women.

• Men between 40 and 50 years of age.

• Family history of gout.

• Consuming more of purine-rich food like red meat, shellfish, etc.

• Consuming more alcohol.

• Taking medicines like Cyclosporine or diuretics.

• Hypertension.

• Kidney disease.

• Thyroid disease.

• Diabetes.

• Sleep apnea.

How Is Gout Diagnosed?

Depending on the clinical presentation, medical history, and physical examination, your doctor will come to a diagnosis. If necessary, you might need to do the following tests:

• Blood test - To check the level of uric acid and creatinine. Diagnosis cannot be made only based on the levels of uric acid, as some people with high uric acid do not develop any symptoms.

• Joint fluid test - A needle is used to draw fluid from the joint, and urate crystal can be seen under a microscope.

• X-ray - To rule out other causes of joint pain.

• Ultrasound and CT scan - To detect urate crystals in the joint.

What Are the Treatment Options for Gout?

Medications:

• Drugs used to treat acute attacks of gout are as follows:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) - Ibuprofen, Naproxen, Indomethacin.

  • Colchicine.

  • Corticosteroids - Prednisone.

• Drugs to help reduce uric acid levels:

  • Block the production of uric acid - Xanthine oxidase inhibitors (Allopurinol, Febuxostat).

  • Aid in uric acid removal - Uricosurics (Probenecid, Iesinurad).

Home Remedies:

• Avoid alcoholic and sweetened beverages.

• Limit consumption of red meat, organ meat, and shellfish.

• Exercise regularly.

• Foods like coffee, vitamin C, and cherries can be used to lower uric acid levels.

How to Prevent Gout?

Steps to prevent gout are:

• Do not drink.

• Eat a diet low in purine-rich food.

• Consume a low-fat diet.

• Reduce weight.

• Quit smoking.

• Drink a lot of water.

What Are the Complications of Gout?

Some of the complications are:

• Recurrent gout may lead to permanent joint destruction.

• Tophi can form in different parts of the body.

• Kidney stone.

• Chronic gout leads to impaired renal function, and may cause secondary hypertension.

If your pain is getting worse and gout attacks are becoming frequent, consult a rheumatologist online now.

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