Understanding gout: A type of arthritis

Arthritis is a painful swelling of the joints, the areas where two or more bones meet. It's estimated that more than 54 million adults in the U.S. have some kind of arthritis. It's also estimated that by 2040, more than 78 million adults will have arthritis.

Gout is a form of arthritis that causes sudden pain, swelling and tenderness in the joints. It’s often associated with high blood pressure, obesity, diabetes and long-term kidney disease. 

Three stages of gout

An acute (sudden) attack of gout often happens in a single joint in the legs, such as the base of the big toe. It can also happen in any joint, bursa, tendon or in the spine. Gout causes severe pain, redness, swelling and warmth.

Gout typically peaks in 12 to 24 hours. Swelling can go beyond the joint. Someone with gout can also have a fever. Attacks usually start at night when the body’s levels of uric acid are higher.

Pain with gout often goes away on its own in a few days or a week. But if someone with gout doesn't get care, multiple areas of the body an be affected at the same time.

Intercortical gout refers to the time between gout attacks. During this period, you won’t have any symptoms, and you might go months or years before another acute attack. However, if you don’t get treatment for your gout, this period tends to get shorter.

Tophaceous gout occurs when a large number of urate crystals, fibrous tissue and inflammatory cells form on the ears, joints, tendons or bursa. This usually isn’t painful, but it can damage the surrounding area. These growths rarely happen before a first acute attack.

Your chances of getting gout

Factors that increase your chances of getting gout:

• Male
• Age 45 or older
• Of Asian or Pacific Islander heritage
• Obese or overweight
• Taking diuretics
• Chronic kidney disease
• A family history of high uric acid
• Organ transplant
• High blood pressure
• A diet that includes:
  • Beer and hard liquor
  • Meat and seafood
  • High fructose

Diagnosis and care

Doctors can figure out if you have gout by doing:

• A clinical history and descriptions of your symptoms
• A joint fluid analysis to look for uric acid crystals
• A blood test to measure your uric acid level

Care for acute gout attacks may include: 

• Steroid shots
• Anti-inflammatories, such as indomethacin or ibuprofen
• Steroid pills, such as prednisone or Medrol
• Colchicine

Long-term medication to help stop gout is recommended for people with: 

• Many or disabling gout attacks
• Joint damage
• Tophi
• Kidney disease
• Uric acid kidney stones

How to stop gout

• Eat low-fat dairy
• Eat less meat and seafood
• Drink fewer sugary beverages
• Drink less or no alcohol  
• Maintain a healthy weight

Talk with your doctor

If you think you have gout, talk with your doctor. You may be referred to a rheumatologist, who specializes in diseases of the joints, muscles and bones. Gout is treatable and can be managed before permanent joint damage or deformities happen.

By Jane Park, MD

Source

• Centers for Disease Control and Prevention. Arthritis: National Statistics. Accessed November 11, 2020.
  

The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs.