Gout is a form of arthritis that causes painful, swollen, red and inflamed joints. Gout is caused by a buildup of uric acid that forms crystals in the joints and surrounding tissue. Uric acid is a natural waste product of the body that is normally filtered out of the bloodstream by the kidneys and excreted during urination. Patients with gout have an abnormal metabolism that reduces the effectiveness of the kidneys, causing uric acid to accumulate in the blood.
Risk Factors for Gout
Gout affects men more often than women because men tend to have higher levels of uric acid. Additional factors that increase the body's uric acid levels and, thus, the risk of developing gout may include the following:
- Excessive alcohol use
- High blood pressure
- High cholesterol
- Certain medications
Gout may be more common in people who have a family history of the condition.
Symptoms of Gout
Most symptoms of gout come on suddenly, without warning, and primarily affect the big toe. However, the feet, ankles, hands and wrists can also be affected. Symptoms, which are usually the most intense in the initial 12 to 24 hours of their onset, may include the following:
- Severe joint pain
- Inflammation and redness
- Lingering pain or discomfort
Parts of the body affected by a gout attack may feel hot to the touch, and people with gout may experience a continuous throbbing or stabbing pain in the affected joint.
Complications of Gout
Left untreated, severe cases of gout can cause urate crystals (the salt of uric acid) to form nodules beneath the skin. These nodules, called "tophi," can form on fingers, toes, hands, feet or elbows. During attacks of gout, tophi may become swollen and tender. In addition, urate crystals can develop in the urinary tract, and lead to the development of kidney stones.
Diagnosis of Gout
To diagnose gout, symptoms are reviewed and a physical examination is performed. Fluid in the joints is extracted and tested for the presence of urate crystals, and blood tests are administered to measure the levels of uric acid in the blood.
Treatment of Gout
Treatment of gout includes medication to relieve symptoms of pain and inflammation, and may include the following:
- Nonsteroidal anti-inflammatory drugs
Other medication may be prescribed to block the body's acid production or to improve the kidneys' ability to remove uric acid. Certain dietary changes, such as eating moderate amounts of protein and drinking plenty of water, may also help reduce the amount of uric acid in the blood. Limiting alcohol intake and maintaining a healthy weight can also help to reduce gout attacks.