Gout is a general term for a variety of conditions that are
caused by a buildup of uric acid. This buildup usually affects the feet, particularly
the big toe. People who have gout feel swelling and pain in the joints of the
foot. Sudden and intense pain, or gout attacks, can make it feel like your foot
is on fire.
Hyperuricemia, acute gout, and tophus gout are all different
types of clinical presentations of gout that vary in symptoms and treatment.
Hyperuricemia is an overproduction of uric acid and is seen in the beginning
stage of gout. Acute gout is a condition in which you have several attacks,
typically affecting the joints, over several years, depending on the uric acid
in your system. Tophus gout is a condition that happens when gout is left
untreated. The symptoms of this form of gout can become more symptomatic with acute episodes of gout arthritis. It is
characterized by hard nodules (tophi) that develop in the skin and soft tissue
surrounding joints as well as in the joints themselves, leading to arthritis.
Causes of Gout
Gout is a complex disease. There are a variety of factors
that can play a role in causing it. Certain conditions, such as blood and
metabolism disorders, can cause your body to produce too much uric acid.
Drinking too much alcohol can also cause you to produce too much uric acid.
Certain foods can also cause gout when you eat too much of them. These include:
- sweet juices
Gout can also be caused by your body’s inability to
eliminate uric acid. Being dehydrated or starved can make it difficult for your
body to excrete the uric acid, causing it to build up as deposits in your
joints. Some diseases and disorders, such as kidney or thyroid problems, can
also impair your body’s ability to eliminate uric acid. Certain medications,
such as diuretics and immunosuppressive fungal medications like cyclosporine,
can make elimination of uric acid difficult.
Gout Risk Factors
Risk factors for gout include:
- age: Men between 40 and 50 and post-menopausal women
are more likely to develop gout.
- gender: Men are overall more likely than women
to get gout.
- family history: If you have someone in your
family with gout, you may be more likely to have it as well.
- other conditions: High blood pressure, kidney or
thyroid disease, and diabetes can all put you at risk for gout.
- medications: Some medications (diuretics,
cyclosporine) can put you at risk for gout.
- diet: Eating excessive amounts of food that have
purine puts you at risk for gout.
- drinking alcohol: Drinking excessively (more
than two drinks a day) puts you at risk for gout.
Your doctor can make a diagnosis of gout based on a review
of your medical history, a physical exam, and your symptoms. The doctor usually
bases the diagnosis on your description of the joint pain, if you have had more
than one an episode of intense pain in your joint, and how red or swollen the
area is. If your doctor isn’t sure, they may order a test to see if you have a
buildup of uric acid in your joint. If the test confirms this, a diagnosis of
gout is provided.
Tests and Treatments for Gout
Your doctor may want to confirm the
diagnosis of gout by taking a sample (culture) of the fluid in your joint to
see if it contains uric acid. Your doctor may also want to take an X-ray of the
Your doctor will treat your gout in based on how serious it
is. Some medications that are normally prescribed include:
medications: colchicine, non-steroid anti-inflammatory drugs (NSAIDs)
- corticosteroids to reduce inflammation in the
- anti-gout medications to reduce the uric acid in
your body (allopurinol)
- anti-gout medications that help your body
eliminate uric acid
Along with medications, your doctor may recommend lifestyle
changes to manage gout and reduce your risks for more attacks. Diet changes,
reducing alcohol intake, weight loss, and quitting smoking can help treat gout.
Doctors Who Treat Gout
Your regular doctor can treat your gout. If you have severe
complications or develop tophus gout, your doctor may recommend that you see a
doctor that specializes in arthritis (a rheumatologist).
Complications of Gout
If left untreated, gout can eventually lead to a buildup of
tophi near the site of inflammation. This can lead to arthritis, a painful
condition in which the joint is permanently damaged and swollen.
Fortunately, there is a lot you may be able to do to prevent
gout. You can take the following measures:
- Limit how much alcohol you drink.
- Limit how much foods with purine (shellfish,
lamb/pork/meat) you eat.
- Eat more vegetables and a low-fat non-dairy diet.
- Lose weight.
- Stop smoking.
- Exercise and make sure you are hydrated.
If you have medical conditions or take medication that can
cause gout, work closely with your doctor to determine the best way to avoid