What is gout?
Gout is a type of arthritis that causes pain and swelling in your joints, usually as flares that last for a week or two, and then go away. Gout flares often begin in your big toe or a lower limb.
Gout happens when high levels of a substance called serum urate build up in your body. When this happens, needle-shaped crystals form in and around the joint. This leads to inflammation and arthritis of the joint. However, many people with high levels of serum urate will not develop gout.
With early diagnosis, treatment, and lifestyle changes, gout is one of the most controllable forms of arthritis.
Who gets gout?
Many people develop gout:
- It is more common in men than in women.
- Gout usually develops in middle age; women usually do not develop gout before menopause.
- Rarely, younger people develop the disease; however, if they do, the disease tends to be worse.
What are the symptoms of gout?
The most common symptom of gout is pain in the affected joint, such as the big toe. Gout flares often start suddenly at night, and the intense pain may wake you up. In addition, your joint may feel swollen, red, warm, and stiff.
Gout flares usually occur in one joint. They can be triggered by:
- Certain foods.
- Certain medications.
- Physical trauma.
- Certain illnesses.
Flares typically get better over a week or two. In between flares, you usually don’t have symptoms. Some people may have frequent flares, while others may not have another flare for years. However, over time, if left untreated, your flares may last longer and happen more often.
Some people with gout may be more likely to develop other conditions or complications, especially with the heart and kidneys.
What causes gout?
Gout happens when urate, a substance in your body, builds up and forms needle-shaped crystals in your joints. This leads to:
- Changes in how you move and use the affected joint.
The following factors can make it more likely for you to develop gout:
- High urate levels; however, not everyone who has high levels develops gout.
- A family history of gout.
- Being older.
- Drinking alcohol.
- Eating foods that are rich in purines (usually from animal sources), a substance that breaks down into urate.
- Drinking beverages that have high-fructose corn syrup, such as soda.
- Some health conditions, such as overweight or obesity, high blood pressure, and chronic kidney disease.
- Some medications.
Is there a test for gout?
There is no one test for gout, and its symptoms are similar to several different conditions. To see if you have gout, your health care provider may:
- Ask you to provide your medical history, including:
- Your symptoms.
- Any other medical problems you have.
- Any medications you are taking.
- Examine the affected joints.
- Order laboratory tests, take a sample of fluid from one of your painful joints, or order imaging tests.
How is gout treated?
Treatment may be different for each person. However, the goals for treating gout are the same for each person and include:
- Reduce the pain from gout flares.
- Prevent future flares.
- Stop damage to your joints.
- Care for other conditions or complications that happen with gout.
Your doctor may recommend:
- Taking medications to manage the cause of your gout and treat active gout flares.
- Making changes to your diet and lifestyle.
Who treats gout?
Health care providers who may provide treatment for gout include:
- Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.
- Dietitians, who can teach you about how to follow a healthy diet to improve your health.
- Nurse educators, who specialize in helping people understand their overall condition and set up their treatment plans.
- Pharmacists, who dispense medications and teach people about the medications, including the importance of taking them as prescribed.
- Primary care providers (PCPs), such as internists, who specialize in the diagnosis and medical treatment of adults. Most people with gout are managed by their PCPs.
Living with gout
You can do many things to help manage gout, such as:
- Losing weight, which helps reduce urate levels and can help stop or lower the number of flares you have if you are overweight or obese.
- Making diet changes, such as:
- Drinking less alcohol, including nonalcoholic beer.
- Avoiding drinks that have high-fructose corn syrup, such as soda.
- Avoiding red meats and organ meats (liver, kidney, tongue, and sweetbreads).
- Avoiding seafood, such as shellfish (shrimp and lobster), sardines, and anchovies.
- Eating a healthy and balanced diet that includes plenty of vegetables, fruits, and whole grains, as well as low-fat or fat-free dairy products, poultry, and oils.
- Limiting foods high in saturated fats, as well as sugar-sweetened foods and drinks.
- When you have a gout flare, you can help reduce symptoms from the flare by:
- Putting ice on the affected area to help reduce swelling and pain.
- Elevating the affected limb, if possible, to help reduce swelling.
- Resting the affected joint.
Always talk with your doctor before making any changes to your diet or medications.