Gout

Gout is a common, highly painful form of arthritis caused by uric acid crystals in the joints, often starting in the big toe. Uric acid is formed by the breakdown of purines, which are organic compounds found in soft tissues and certain foods. When there’s too much uric acid in your blood, it can collect as crystals in the joints. Gout alternates between periods of symptom flares and remission, with weeks to years separating the two. This condition has no cure, but medications can relieve symptoms and lifestyle changes may reduce the risk of flares.

Risk Factors for Gout

Men are much more likely than women to develop gout. Factors that can increase your risk include:

• A diet that includes a lot of red meat, liver, tuna, mackerel, herring, sardines, scallops, mussels and other purine-rich foods
• A family history of gout
• Alcohol consumption
• Congestive heart failure
• Diabetes
• High blood pressure
• Insulin resistance
• Obesity
• Organ transplantation
• Reduced kidney function
• Use of aspirin and other drugs with salicylate
• Use of diuretics
• Use of the drugs levodopa and cyclosporine
• Use of the vitamin niacin

Symptoms of Gout

Gout can affect any joint, but it’s more common in the toes, ankle and knee. The condition rarely affects more than one joint at once. During flares, an affected joint may be painful, stiff and swollen, as well as red and warm to the touch.

Diagnosis of Gout

Your physician will ask about other medical conditions you may have and the medications you take. Be prepared to provide detailed information about your symptoms, including which joint is affected, what the pain feels like, when it began and how long it’s been going on.

• Physical exam. The physician will examine the affected joint signs of gout, such as swelling and heat.
• Imaging tests. An X-ray, ultrasound or MRI allows the physician to assess the condition of the joint and rule out other possible causes of your symptoms.
• Blood test. High levels of uric acid in your blood are a clue that gout may be present.
• Fluid sample. The physician may wish to draw fluid from the affected joint to look for uric acid crystals.

Treatment for Gout

Most of the treatments for gout involve lifestyle changes that can help keep patients in remission as long as possible. If you have gout, you should avoid alcohol and foods that are high in purines and fructose. Drinking plenty of water can lower uric acid levels in the blood, and low-impact physical activity contributes to weight loss and can reduce joint pain. Stress can fuel flares, so try to reduce stress levels.

Medical options to relieve pain and swelling include nonsteroidal anti-inflammatory drugs such as aspirin, oral or injectable corticosteroids, and colchicine.