All about gout

What is gout?

Gout is a common form of arthritis that can affect anyone. But it tends to be more complex than other kinds of arthritis.

People with gout might have:

• Sudden, severe attacks of pain in one or more joints
• Swelling and tenderness in one or more joints
• Redness around the joints

Gout most often comes up in the big toe. But it can affect other joints, too.

No matter where it appears, gout can come on suddenly. It often wakes up people in the middle of the night with the sensation that a joint is on fire. The joint may feel swollen, hot to the touch and so tender that even the weight of a sheet on it may seem like too much to handle.

Other symptoms can include:

• Lingering discomfort
  • After the most severe pain goes away, some joint discomfort may last from a few days to a few weeks.
  • Later attacks are likely to last longer and affect more joints.
• Limited range of motion
  • As gout progresses, you may not be able to move your joints normally.

What causes it?

The cells in our bodies give off waste called uric acid. Uric acid is filtered out of the blood by kidneys and leaves your body when you urinate.

Uric acid has salts in it called urates. When the body can’t process uric acid properly, those urates can build up, clump together and crystallize in the joints. This can cause sudden pain and swelling that is typical of a gout flare-up.

Risk factors include:

• Diet
  • Red meats and organ meats, such as liver
  • Certain seafoods like sardines, anchovies, mussels, scallops, trout and tuna
  • Alcohol, especially beer
  • Drinks sweetened with fruit sugar (fructose), like juice

• Weight
  • If you’re overweight, your body creates more uric acid and your kidneys have a harder time getting rid of it

• Medical conditions
  • Untreated high blood pressure
  • Diabetes
  • Obesity
  • Metabolic syndrome
  • Heart disease
  • Kidney diseases

• Certain medications
  • Low-dose aspirin
  • Some medications used to lower blood pressure, including thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, and beta-blockers
  • Anti-rejection drugs prescribed for people who have had an organ transplant
  • Immunosuppressants prescribed for people who have an autoimmune disorder

• Family history of gout
  • If other members of your family have had gout, you’re more likely to develop the disease

• Age and sex
  • Gout occurs more often in males
  • Men are also more likely to develop gout earlier—usually between the ages of 30 and 50—whereas women are usually more at risk for gout after menopause

• Recent surgery or trauma
  • Experiencing recent surgery or trauma can sometimes trigger a gout attack

How is gout diagnosed?

There are several tests your doctor can order for you if you think you might have gout:

• Blood tests: to check your uric acid level
• Joint fluid aspiration: if you have a swollen joint, a healthcare professional can remove some sample fluid from the joint to see if it contains uric acid crystals
• Imaging studies: an x-ray can help you see if your joints have been reshaped by gout

Can gout be treated?

Yes! Your doctor might prescribe medication to treat gout if you have it. Reaching a healthy weight and eating a gout-friendly diet can also help lower the risk of a flare-up in the future.

If you experience sudden, intense pain in a joint, call your doctor. Gout that goes untreated can lead to worse pain and even joint damage.

Seek medical care right away if you have a fever and your joint is hot and inflamed. This can be a sign of an infection.