What is gout?
A buildup of uric acid, caused by purines in the body, causes gout. Foods that are high in purines include all alcoholic drinks, shellfish and certain other types of fish, bacon, turkey, veal, liver, and venison.
Gout is a form of arthritis that often affects your big toe joint. It can also affect your other toe joints, the ankles, and the knees.
People who have gout experience flare-ups, during which the pain is worse, and periods of remission, which have less pain. Flare-ups can start suddenly, and may last for anywhere from a few days to a few weeks. Periods of remission can last up to a few years.
In the distant past, people thought gout was a disease only rich people or royalty could get. This is because it is caused by drinking alcohol and eating foods that were only available to the wealthy at the time.
Signs of gout
The main sign of gout is pain and swelling of the affected joint. The joint may also be red and feel warm.
Your first gout flare-up may be shorter and less severe. Subsequent flare-ups are usually longer and progressively more painful.
Causes of gout
A buildup of uric acid in the body causes gout. Under normal circumstances, uric acid dissolves in your blood. However, sometimes it does not dissolve and instead turns into sharp, pain-causing crystals. These crystals are also a cause of kidney stones.
The buildup of this acid is caused by purines. This substance is in food and in your body's tissue naturally. Foods that are high in purines include:
- All alcoholic drinks
- Shellfish
- Certain other types of fish, like anchovies, sardines, codfish, trout, and haddock
- Bacon
- Turkey
- Veal
- Liver
- Venison
There is another similar condition called pseudogout. It has very similar symptoms to gout, but it is caused by a buildup of calcium phosphate instead.
- Risk factors for gout include:
- Being a man
- Being overweight
- Having someone in your family who also has gout
- Taking diuretics
- Drinking alcohol frequently
- Eating too many foods with purines
- Eating too much fructose
- Having one of the following conditions:
- High blood pressure
- Diabetes
- Congestive heart failure
- Kidney problems
- Metabolic syndrome
QUESTION
Gout is a form of arthritis.
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Diagnosis and tests for gout
Your doctor will first take a detailed medical history to find out more about your symptoms. They will then do a physical exam to rule out other conditions that may cause joint pain.
To confirm the diagnosis, your doctor might take an X-ray of the affected joint. They may also take a sample of the fluid from the painful joint to test it for uric acid and rule out other conditions like bacterial infections.
Gout may be hard to diagnose in some cases, because it may be similar to other forms of arthritis. However, with a combination of an interview, a physical exam, and testing, your doctor can diagnose you.
Treatment for gout
Lifestyle changes
Doctors often recommend that people with gout make lifestyle changes to reduce purines in their diet and lessen other risk factors.
These changes may include:
- Limiting alcohol drinking
- Eating a healthy diet with fewer foods that have purine
- Exercising regularly
- Trying to lose weight
When making lifestyle changes like exercising more frequently, be sure to choose activities that will be easy on your joints. Otherwise, you could make your gout worse.
Medications
Your doctor may prescribe medication to help prevent gout attacks by reducing uric acid levels. These medications include:
- Allopurinol
- Febuxostat
- Probenecid
- Pegloticase
They may also direct you to take over-the-counter or prescription pain medication to reduce pain during a flare-up. These include non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen.
Sometimes, doctors may prescribe a steroid injection or oral steroids. The anti-inflammatory medication colchicine is often prescribed in conjunction with one of the aforementioned drugs that reduce uric acid levels.