What is gout?
If you have gout, your body makes too much uric acid. Uric acid forms normally as your body breaks down old cells and makes new cells. In gout, the uric acid forms into crystals that sometimes deposit in or around your joints. The crystals cause severe joint pain, redness, and swelling.
Gout comes in sudden attacks that usually affect only one joint
The attacks go away in a few days
Some people have several attacks a year
If you have a lot of attacks, your joints may be damaged and may hurt all the time
Gout is more common in men than in women
Gout usually happens during middle age, but younger people can get gout
To see if you have gout, doctors may use a needle to take fluid from your joint for tests
Doctors treat gout attacks with medicine to lessen pain and swelling
If you have frequent attacks, you may need medicine to help prevent them
What causes gout?
Gout is caused by high levels of uric acid in your blood. Very high levels of uric acid can form microscopic crystals that build up in your joints or under your skin (tophi). The buildup of crystals causes swelling and pain and may lead to joint damage.
You’re more likely to get gout if you:
Have a close relative with gout—gout runs in families
Have kidney problems, such as kidney disease
Drink a lot of alcohol
Eat a lot of certain foods that increase uric acid levels—such as liver, kidney, herring, mussels, sardines, asparagus, and mushrooms
Take certain medicines
Have lead poisoning (when lead builds up in your body)
Are overweight or obese
Have metabolic syndrome (a condition that can cause a large waist, high blood pressure, and high blood sugar levels)
Are having chemotherapy or radiation treatment for cancer
If you have gout, then an injury, sickness, or having surgery can trigger attacks.
What are the symptoms of gout?
Usually, you'll have sudden, severe pain in your joint.
Your joint becomes:
Warm
Red
Swollen
You may also have other symptoms such as:
Fever
Feeling sick
Your first attack usually affects only the big toe. Other joints may also be affected at times, such as:
Joints in your foot other than the big toe
Ankle
Knee
Wrist
Elbow
Even without treatment, your symptoms will slowly go away, and you won’t have them again until your next gout attack.
Treatment will help the symptoms go away quicker. Treatment may also help prevent more severe attacks that affect more than one joint and that last up to 3 weeks.
Over time, you may have joint stiffness or joint damage. Hard lumps (tophi) can form under the skin around your joints. Certain medicines can help prevent the lumps or treat them.
About 1 in 5 people with gout also get kidney stones, which cause pain and kidney problems.
How can doctors tell if I have gout?
Doctors suspect gout based on your symptoms and an exam.
To tell for sure, doctors will do tests, such as:
Taking a small amount of fluid from your joint (joint aspiration)—doctors will look at the fluid under a special microscope to see if it has uric acid crystals
An x-ray of your joint to look for bone changes that are common in gout
An ultrasound to look for uric acid crystals inside your joint
Doctors may also do a blood test to check the level of uric acid. But your level may not be high even though you have gout.
How do doctors treat gout?
Doctors may:
Give you pills to lessen your pain and swelling
Rarely, inject medicine into your joint
Have you use a splint
Have you rest your joint, and apply ice to your joint for 20 minutes every few hours
If you're at risk or have uric acid kidney stones, tell you to drink 3 liters or more of fluids each day—about 12 8-ounce glasses of water
If you have uric acid stones in your urinary tract, doctors sometimes use sound waves to break up the stones so you can pass them in your urine.
If you have large lumps (tophi) around your joints that don't disappear with treatment, doctors may do surgery to take them out.
How can I prevent gout attacks?
To prevent future gout attacks, doctors will tell you to:
Not drink alcohol
Lose weight
Stop taking medicine that raises levels of uric acid
Eat less foods that raise levels of uric acid
Sometimes, doctors will have you take medicine daily to lower the level of uric acid in your blood.
