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Gout: Causes & Symptoms & Treatments

What is gout?

Gout is a type of arthritis that causes sudden joint inflammation, usually in a single joint. Severe gout can sometimes affect many joints at once. This is known as polyarticular gout.

Uric acid crystals in the joints cause gouty arthritis.

What causes gout?

Gout is caused by too much uric acid in the bloodstream and accumulation of uric acid crystals in tissues of the body. Uric acid crystal deposits in the joint cause inflammation of the joint leading to pain, redness, heat, and swelling. Uric acid is normally found in the body as a byproduct of the way the body breaks down certain proteins called purines. Causes of an elevated blood uric acid level (hyperuricemia) include genetics, obesity, certain medications such as diuretics (water pills), and chronic decreased kidney function.

What are risk factors for gout?

There are many risk factors for gout. Gout is more common after surgery, trauma, and dehydration. Certain medications such as diuretics (commonly known as water pills), which treat high blood pressure, that raise the level of uric acid in the bloodstream are risks for gout. Surprisingly, medications that lower the level of uric acid in the bloodstream, such as allopurinol (Zyloprim, Aloprim), can also initially cause a flare of gout. This is because anything that raises or lowers the uric acid level can cause a gout flare by causing uric acid crystals to deposit in a joint. Low-dose aspirin can precipitate gout attacks. The treatment of certain types of cancer can cause gout because of high levels of uric acid released when the cancer cells are destroyed. Degenerative arthritis also makes affected joints more likely to be the site of a gouty attack.

What are gout symptoms and signs?

The characteristic symptoms and signs of gout are

  • sudden onset of joint pain,
  • joint swelling,
  • heat in the affected area, and
  • joint redness.

These symptoms and signs usually affect a single joint. The pain is typically severe, reflecting the severity of inflammation in the joint. The affected joint is often very sensitive to touch to the point that some people with gout attacks experience pain from something as simple as pulling the bedsheets over the inflamed joint. The affected joint becomes swollen. The medical term for excessive fluid in a joint is a “joint effusion.”

Gout frequently involves joints in the lower extremities. The classic location for gout to occur is the big toe. Podagra is the medical term for inflammation at the base of the big toe. Gout can also affect the foot, knee, ankle, elbow, wrist, hands, or nearly any joint in the body. When gout is more severe or longstanding, multiple joints may be affected at the same time. This causes pain and joint stiffness in multiple joints.

Another sign of gout is the presence of tophi. A tophus is a hard nodule of uric acid that deposits under the skin. Tophi can be found in various locations in the body, commonly on the elbows, upper ear cartilage, and on the surface of other joints. When a tophus is present, it indicates that the body is substantially overloaded with uric acid. When tophi are present, the uric acid level in the bloodstream typically has been high for years. The presence of tophi indicates tophaceous gout and treatment with medications is necessary.

Longstanding untreated gout can lead to joint damage and physical deformity.

Kidney stones may be a sign of gout as uric acid crystals can deposit in the kidney and cause kidney stones.

Treatments:

The good news about gout is that it can be controlled. Medicines help in two ways: They reduce pain during an attack, and can reduce the uric acid buildup that causes the condition.

When uric acid builds up in your body, it can form crystals that irritate your joints.

Gout is a type of inflammatory arthritis. An attack may come after an illness or injury. The first sign is often pain in the big toe. It usually affects one joint at a time, but gout can spread to other joints and leave them looking red and swollen.

Prescription Medicines

Your doctor may recommend one of these medicines that you can’t get over the counter:

  • Indomethacin is a stronger NSAID pain reliever.
  • Colchicine reduces inflammation.
  • Steroids (also called corticosteroids) fight inflammation.
  • Probenecid helps the kidneys excrete uric acid from your body.
  • Pegloticase breaks down uric acid.
  • Allopurinol reduces uric acid production.
  • Febuxostat reduces uric acid production.
  • Lesinurad helps your body get rid of uric acid when you pee.

Preventive Measures

Along with medicine, your doctor may suggest other ways to prevent another attack:

  • Exercise and eat a balanced diet to control your weight.
  • Drink lots of water.
  • Stay away from sugary drinks.
  • Avoid excessive alcohol use, especially beer.
  • Eat less meat and seafood. Get your protein from foods like low-fatdairy. products like yogurt, cheese and milk.

These medicine and lifestyle change can help you get through an attack and prevent other attacks.

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