Gout

What is Gout?

Gout is a type of arthritis that causes sudden, intense pain, redness, and swelling in the joints. It happens when there is too much uric acid in the blood, which can form crystals that get trapped in the joints. These urate crystals signal the body to send blood and inflammatory element to the affected joint. This creates intense pain and swelling. Uric acid is produced when the body breaks down purines, substances found in some foods like red meat, shellfish, and alcohol. Gout most often affects the big toe, but it can also occur in other joints like the knees, ankles, and elbows. People who are more likely to get gout include those who are overweight, have high blood pressure, drink a lot of alcohol, or have a family history of gout. It is also more common in men and tends to occur in middle age or later.

Diagnosing Gout

Gout is diagnosed by a doctor through a combination of reviewing the medical history, performing a physical exam, and ordering specific tests. During the exam, the doctor will check for signs of gout, like swollen, red, and painful joints –especially in the big toe. They may ask about diet, lifestyle, and family history, as these can help determine if a patient is at risk for gout. To confirm the diagnosis, doctors may take a sample of fluid from the affected joint using a needle. This fluid is checked under a microscope for uric acid crystals, which are a clear sign of gout. Blood tests can also measure uric acid levels, but a high level doesn’t always mean someone has gout. In some cases, doctors might use X-rays to rule out other joint problems.

Treatment of Gout

Gout is typically treated with medications to relieve pain, reduce inflammation, and lower uric acid levels in the blood. During an acute gout attack, doctors may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, or stronger medications like colchicine to reduce pain and swelling. For long-term treatment gout, medications such as allopurinol or febuxostat are used to lower uric acid levels in the blood, helping prevent future gout attacks. Doctors may also recommend lifestyle changes, like eating fewer foods high in purines (such as red meat and seafood), drinking less alcohol, staying hydrated, and maintaining a healthy weight. These treatments help manage symptoms and prevent gout from getting worse.

Edited by Stephen Pinney MD November 12th, 2024