Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Gout is inflammation in and around joints due to uric acid crystals. It leads to painful, stiff joints.

Causes

Uric acid comes from the break down of purine from food or human cells. Sometimes the body makes too much uric acid or has difficulty passing uric acid out of the body through the kidneys. When uric acid levels get too high it may lead to the formation of uric acid crystals in joints and gout.

Risk Factors

Gout is more common in men over the age of 30 years, but gout can occur in men and women at any age. Other factors that may increase your risk of gout include:

Certain foods and beverages may also increase your chances of gout.

  • Foods high in purines, such as organ meats, shellfish, some vegetables, and gravies
  • High-fructose drinks, such as sugar-sweetened sodas and orange juice
  • Excess alcohol, especially beer

Symptoms

Symptoms may include:

  • Sudden onset of severe pain in an inflamed joint, usually starting in the big toe
  • Joints that are red, hot, swollen, and tender
  • Increased pain 24-48 hours after the onset of symptoms

Gout of the Big Toe

Copyright © Nucleus Medical Media, Inc.

Most people with gout have another attack. This attack may affect many different joints. With recurrent gout, tophi can form. Tophi are chalky deposits of uric acid that most commonly occur in the elbows and earlobes, but may form anywhere

Gout can also lead to other health problems, such as:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A sample of fluid from the affected joint will be taken. This fluid will be tested for uric acid crystals.

Your bodily fluids may be tested. This can be done with:

  • A sample of fluid taken from the affected joint
  • Blood tests
  • Urine tests

Images may be taken of your bodily structures. This can be done with:

Treatment

Treatment depends on whether the gout is acute or recurrent.

In general, the sooner treatment begins for an acute attack, the more effective it is. Treatment depends on:

  • The number of joints affected
  • Previous responses to treatment
  • Overall health

Putting an ice pack on the joint may ease the pain. Keeping the weight of clothes or bed covers off the joint can also help.

Medications may include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Corticosteroids—may be given orally or as an injection into the affected joint
  • Colchicine

General measures used to treat recurrent gout include:

  • A low purine diet
  • Alcohol avoidance
  • Gradual weight loss in those who are obese
  • Stopping or changing medications that may be causing recurrent gout
  • Increasing fluid intake

If you have recurrent gout, or you have kidney stones, tophi, or reduced kidney function, you may be given medications to:

  • Lower the production of uric acid
  • Increase the excretion of uric acid by the kidneys
  • Convert uric acid into a different byproduct

Prevention

To help reduce your chance of getting gout:

  • Eat a low-purine diet.
  • Limit how much alcohol you drink. Avoid binge drinking.
  • Drink a lot of fluids.
  • Lose weight gradually.