Gout is inflammation in and around the joints.
Uric acid forms when the body breaks down the chemical called purine. The body makes purines and it can also be found in some foods. Sometimes the body makes too much uric acid. It may also have problems passing uric acid out of the body through the kidneys. Uric acid crystals form when uric acid levels get too high. This leads to gout.
Gout is more common in men and older adults.
The main risk factor is having high levels of uric acid in the blood. Other things that may raise the risk are:
- Eating foods high in purines, such as red meat, seafood, and alcohol
- Eating or drinking things that are high in fructose, such as sugary drinks
- Some medicines, such as diuretics, cyclosporin, and chemotherapy drugs
- Having certain health problems, such as congestive heart failure, high blood pressure, or kidney disease
Problems may be:
- Sudden severe pain in a joint, usually starting in the big toe
- Joints that are red, hot, and swollen
The pain may last a few days or weeks. It may go away and then come back. It often affects only one joint at a time.
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The doctor will ask about symptoms and health history. A physical exam will be done.
Uric acid levels will be tested. This can be done with:
- Joint fluid tests
- Blood tests
- Urine tests
Pictures may be taken of the joint. This can be done with:
The goal of treatment is to manage symptoms and prevent flare-ups. This can be done with:
- Supportive care, such as keeping clothes or bedding off the joint to ease pressure
- Medicines to ease swelling and pain, such as ibuprofen, corticosteroids, and colchicine
- Stopping or changing medicines that may be causing gout
- Dietary changes, such as a low-purine diet and limiting alcohol and sugary drinks
- Lifestyle changes, such as maintaining a healthy weight through diet and exercise
To lower the risk of gout:
- Eat a low-purine diet.
- Limit alcohol and sugary drinks.
- Maintain a healthy weight.
- Gout. American College of Rheumatology website. Available at: http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Gout.
- Gout. Arthritis Foundation website. Available at: https://www.arthritis.org/diseases/gout.
- Gout. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/gout.
- Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/health-topics/gout.
- Gout management—prevention of recurrent attacks. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/gout-management-prevention-of-recurrent-attacks.
- Gout overview. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/gout.
- Pascart T, Lioté F. Gout: state of the art after a decade of developments. Rheumatology (Oxford). 2019 Jan 1;58(1):27-44.
- Warren A. Bodine, DO, CAQSM
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