Gout: Symptoms, causes, and treatment

Gout is a common type of arthritis that causes intense pain, swelling, and stiffness in a joint. It usually affects the joint in the big toe.

Gout attacks can come on quickly and keep returning over time, slowly harming tissues in the region of the inflammation. It has also been related to an increased incidence of cardiovascular and metabolic disease and can be extremely painful.

It is the most common form of inflammatory arthritis in men, and although it is more likely to affect men, women become more susceptible to it after the menopause.

The Centers for Disease Control and Prevention (CDC) report that 8.3 million Americans were affected by gout between 2007 to 2008.

Fast facts on gout

Here are some key points about gout. More detail and supporting information is in the main article.

Gout is a form of arthritis caused by excess uric acid in the bloodstream.

The symptoms of gout are due to the formation of uric acid crystals in the joints and the body’s response to them.

Gout most classically affects the joint in the base of the big toe.

Gout attacks often occur without warning in the middle of the night.

Most gout cases are treated with specific medications.

Treatment

person with gout
Gout patients often have acute inflammation around their joints.

The majority of gout cases are treated with medication. Medication can be used to treat the symptoms of gout attacks, prevent future flares, and reduce the risk of gout complications such as kidney stones and the development of tophi.

Commonly used medications include nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, or corticosteroids. These reduce inflammation and pain in the areas affected by gout and are usually taken orally. Various brands are available to purchase online.

Medications can also be used to either reduce the production of uric acid (xanthine oxidase inhibitors such as allopurinol) or improve the kidney’s ability to remove uric acid from the body (probenecid).

Without treatment, an acute gout attack will be at its worst between 12 and 24 hours after it began. A person can expect to recover within 1 to 2 weeks without treatment.

Tests and diagnosis

Gout can be tricky to diagnose, as its symptoms, when they do appear, are similar to those of other conditions. While hyperuricemia occurs in the majority of people that develop gout, it may not be present during a flare. On top of that, the majority of people with hyperuricemia do not develop gout.

One diagnostic test that doctors can carry out is the joint fluid test, where fluid is extracted from the affected joint with a needle. The fluid is then examined to see if any urate crystals are present.

As joint infections can also cause similar symptoms to gout, a doctor can look for bacteria when carrying out a joint fluid test in order to rule a bacterial cause.

Doctors can also do a blood test to measure the levels of uric acid in the blood, but, as mentioned, people with high uric acid levels do not always experience gout. Equally, some people can develop the symptoms of gout without having increased levels of uric acid in the blood.

Finally, doctors can search for urate crystals around joints or within a tophus using ultrasound or CT scans. X-rays cannot detect gout, but may be used to rule out other causes.

gout on foot

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foot and heel gout

gout on hands

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