What Is Gout? Causes Gout attacks are caused by deposits of crystallized uric acid in the joint. Symptoms An attack of gout can be miserable, marked by the following symptoms: Intense pain that comes on suddenly, often in the middle of the night or upon arising Signs of inflammation, such as redness, swelling and warmth over the joint Diagnosis To diagnose gout, the foot and ankle surgeon will ask questions about your personal and family medical history, followed by an examination of the affected joint.
Treatment Initial treatment of an attack of gout typically includes the following: Medications. Prescription medications or injections are used to treat the pain, swelling and inflammation. Dietary restrictions. Foods and beverages that are high in purines should be avoided since purines are converted in the body to uric acid.
Drink plenty of water and other fluids each day, while also avoiding alcoholic beverages, which cause dehydration. Painful swelling can come and go in the same joint or in different joints.
Gout crystals form when your body makes too much, or does not get rid of, uric acid. Genetics is the main factor in determining uric acid levels. These levels can also be affected by:. Obesity, insulin resistance, high cholesterol, heart disease, hypothyroidism, and kidney disease can be associated with gout. Episodes of gout have been noted after injury or surgery, sometimes involving infection or the use of contrast for x-rays.
Physical fitness seems to help with prevention of gout. Gout leads to attacks, or flares, that appear suddenly with hot, red, or swollen joints. The joints can be so painful that they hurt to move.
Sometimes the joints look like they are infected, even though they are not. These bumps are not painful. The diagnosis for gout is made based on a physical examination by your doctor, x-rays, and lab tests. You will be asked about your symptoms and how gout has changed your activities.
If this isn't suitable or doesn't work, other medications may be used instead. These medications are described below. Allopurinol helps reduce the production of uric acid. It can help prevent gout attacks, although it won't help relieve symptoms during an attack.
Allopurinol is a tablet taken once a day. When you first start taking it, your dose will be adjusted to make sure the level of uric acid in your blood is low enough. Regular blood tests will be needed to monitor this until the most effective dose is found. Allopurinol can sometimes cause a gout attack soon after you start taking it and it can take up to a year or two before no further attacks occur. It's important to persevere with treatment even if you do have attacks during this time.
To help relieve attacks, your doctor will prescribe one of the pain relieving medications described above to take alongside your allopurinol at first. Most people taking allopurinol won't experience any significant side effects. However, side effects can include:. Like allopurinol, febuxostat is a medication taken once a day that reduces the body's production of uric acid.
It's often used if allopurinol isn't suitable or causes troublesome side effects. As with allopurinol, febuxostat can make your symptoms worse when you first start taking it.
Your doctor will initially prescribe one of the pain relieving medications described in case you experience attacks. These types of medication tend to only be used if people are unable to take allopurinol or febuxostat.
They need to be prescribed under the supervision of a specialist. Certain lifestyle changes can also help reduce your risk of experiencing further attacks of gout, including:. There's some evidence to suggest that taking regular vitamin C supplements can reduce gout attacks, although the effect may only be small.
Talk to your GP first if you're thinking about taking vitamin C supplements, as they aren't suitable or safe for everyone. Complications of gout can include small lumps forming under the skin tophi , joint damage and kidney stones.
These are more likely to occur if gout is left untreated. Gout is caused by a chemical called uric acid forming small crystals in and around the joints. These crystals also often build up under the skin and form small white or yellow lumps known as tophi. Tophi are usually painless, but they can form in awkward places, such as at the ends of your fingers and around your toes. Sometimes they can make everyday tasks such as preparing food or getting dressed difficult.
It normally takes several years after the first attack of gout for tophi to develop, but some people develop them even before experiencing an attack. They're usually a sign of severe gout and a good reason to start treatment to reduce the level or uric acid in your body. Successful treatment will prevent the tophi from getting any bigger, and long term treatment often gradually shrinks them. Without treatment, gout attacks may become more frequent and prolonged, and your likelihood of developing permanent joint damage will increase.
Occasionally, high levels of uric acid can lead to the formation of kidney stones. Some kidney stones interfere with the flow of urine, resulting in pain when you pass urine, and can make you feel that you need to pass urine more often. Some kidney stones interfere with the flow of urine, resulting in pain when you pee, and can make you feel that you need to pee more often.
You may be prescribed medication to make your urine less acidic, which should help dissolve any kidney stones that have developed. Read more about treating kidney stones. Gout can also affect your mood, work and home life. The severe pain that gout causes can make it difficult to do everyday tasks and to get around, which in turn can lead to feelings of depression or anxiety.
If gout is affecting your mood or making everyday life difficult, talk to your GP. They will be able to offer treatment and support. There are also a number of organisations that offer information and advice for people who have gout, including Arthritis Research UK and Arthritis Care.
Home Illnesses and conditions Muscle, bone and joints Conditions Gout. Gout See all parts of this guide Hide guide parts 1. About gout 2. Symptoms of gout 3. Causes of gout 4. Diagnosing gout 5. Treating gout 6. Complications of gout. Gout that goes untreated can lead to worsening pain and joint damage.
Seek medical care immediately if you have a fever and a joint is hot and inflamed, which can be a sign of infection. Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines — substances that are found naturally in your body. Purines are also found in certain foods, including red meat and organ meats, such as liver.
Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout and tuna. Alcoholic beverages, especially beer, and drinks sweetened with fruit sugar fructose promote higher levels of uric acid. Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes either your body produces too much uric acid or your kidneys excrete too little uric acid.
When this happens, uric acid can build up, forming sharp, needlelike urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling. You're more likely to develop gout if you have high levels of uric acid in your body. Factors that increase the uric acid level in your body include:.
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