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Gout

(Gouty Arthritis)

Definition

Gout is inflammation in and around joints.

Causes

Uric acid forms when the body breaks down purines in foods. Some foods also contain purines. 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.

Risk Factors

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
  • Obesity
  • Having certain health problems, such as congestive heart failure, high blood pressure, or kidney disease

Symptoms

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.

Diagnosis

You will be asked about your 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:

Treatment

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

Prevention

To lower the risk of gout:

  • Eat a low-purine diet.
  • Limit alcohol and sugary drinks.
  • Maintain a healthy weight.
RESOURCES:

American Arthritis Society
http://www.americanarthritis.org

Arthritis Foundation
https://www.arthritis.org

CANADIAN RESOURCES:

Arthritis Society
https://www.arthritis.ca

Health Canada
https://www.canada.ca

REFERENCES:

Gout. American College of Rheumatology website. Available at: http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Gout. Accessed September 25, 2020.

Gout. Arthritis Foundation website. Available at: http://www.arthritis.org/about-arthritis/types/gout. Accessed September 25, 2020.

Gout. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/gout. Accessed September 25, 2020.

Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Gout/default.asp. Accessed September 25, 2020.

Gout overview. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/gout.html. Accessed September 25, 2020.

Gout management—prevention of recurrent attacks. EBSCO DynaMed website. Available at:https://www.dynamed.com/management/gout-management-prevention-of-recurrent-attacks. Accessed September 25, 2020.

Pascart T, Lioté F. Gout: state of the art after a decade of developments. Rheumatology (Oxford). 2019 Jan 1;58(1):27-44.

Last reviewed September 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM  Last Updated: 9/25/2020