Gout

Overview

Gout is a common type of arthritis that can occur in anyone. Also known as gouty arthritis, this condition can cause sudden, severe pain in the joint affected by the condition. Treatment focuses on treating and reducing the number of flare-ups. 

Gout causes 

Gout is caused by urate crystals that accumulate in the joints, which leads to the swelling and pain of a gout attack.

Gout risk factors

Factors that put you at an increased risk for developing gout include:

• Being a male between ages 30 and 50
• Being a post-menopausal female
• Being obese
• Eating a diet high in meat, seafood or fructose- (fruit sugar) sweetened drinks
• Having diabetes or metabolic syndrome
• Having heart or kidney disease
• Having recently suffered trauma
• Having recently undergone surgery
• Having untreated high blood pressure
• Taking a thiazide diuretic (water pill)
• Taking anti-rejection medications for an organ transplant
• Taking low-dose aspirin

Gout symptoms

Signs and symptoms of gout typically occur at night, and may include:

• An affected joint that feels warm to the touch
• Intense joint pain, especially in the large joint of the big toe
• Periods of extreme joint pain that usually last up to 12 hours, but can last up to a few weeks
• Swelling and redness of the affected joint
• Trouble moving the affected area normally

Gout diagnosis

Your specialist may use one or more of the following tests to diagnose your gout:

• Joint fluid test. In this test, your doctor uses a needle to remove fluid from the affected joint. The fluid is sent to the lab for closer analysis. Urate crystals may be visible in the fluid, which can indicate gout.
• Blood tests. Your doctor may use blood tests to check the levels of uric acid and creatinine in your blood.
• Imaging tests. Your specialist may order imaging tests – such as X-ray, ultrasound or dual energy computerized tomography (CT) scan – to rule out other conditions that cause similar symptoms or visibly check for urate crystals in the joint.

Gout treatment

Your specialist may recommend one or more of the following treatment options for gout:

• Pain relievers. Your specialist may recommend an over-the-counter pain medication – such as ibuprofen (Advil or Motrin) or naproxen sodium (Aleve) to help control your pain. Your specialist may prescribe colchicine (Colcrys or Mitigare) to help control gout pain.
• Corticosteroids. Your specialist may prescribe a corticosteroid – such as prednisone – to help reduce joint inflammation and pain. Prednisone may be administered orally (by mouth) or injected.
• Medications to reduce flare-ups. Your doctor may prescribe medications that can help reduce gout flare-ups. Such medications include xanthine oxidase inhibitors (XOIs) to limit the amount of uric acid your body produces, and uricosuric drugs to help your kidneys remove uric acid from your body.
• Lifestyle modifications. Your specialist may recommend lifestyle modifications to help control your gout flare-ups and symptoms. Such changes include limiting your intake of alcohol and drinks sweetened with fruit sugar, drinking lots of water, limiting your intake of red meat and seafood, exercising regularly and maintaining a healthy body weight.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a rheumatologist for more specialized treatment.