What is Gout?

Gout is a common form of inflammatory arthritis that is very painful. It usually affects one joint at a time (often the big toe joint). There are times when symptoms worsen (known as gout attacks) and times when there are no symptoms (known as periods of remission). Recurrent episodes of gout can cause gouty arthritis, a worsening type of arthritis.

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What causes Gout?

Gout is caused by a condition known as hyperuricemia, in which there is too much uric acid in the body. The body generates uric acid when it breaks down purine, which is found in the body and in the food you eat. When there is too much uric acid in the body, uric acid crystals (monosodium urate) can build up in the joints, fluids, and tissues in the body. Hyperuricemia does not always cause gout, and if there are no symptoms of gout, it does not need to be treated.

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How is Gout diagnosed?

A physician diagnoses gout by evaluating your symptoms and the results of your physical examination, x-rays and laboratory tests. Gout can only be diagnosed during an attack when a joint is warm to the touch, swollen and painful and when a laboratory test finds uric acid crystals in the affected joint.

Sometimes Gout appears in the big toe: Gout Big Toe

Symptoms of Gout

Symptoms of gout usually appear at night. It usually affects one joint at a time, often in the feet, hands, elbows or knees.

“Gout mainly affects middle-aged or older men,” Choi notes. “Postmenopausal women are also at risk, especially if they are obese or have high blood pressure or unhealthy eating habits, such as drinking large amounts of alcohol or sugary soft drinks.”

The risk also increases if you have a family member with gout or if you take certain medications, such as diuretics or low-dose aspirin.

The first attacks of gout tend to go away within a week. It may be months or even years before the next attacks occur. But over time, gout may occur more often and last longer if left untreated.

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Most people with gout can control their symptoms through lifestyle changes and medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve the swelling and pain of sudden attacks. Oral or injected steroids and a medication called colchicine may also help.

If frequent gout attacks become a problem, doctors may prescribe medications to lower uric acid. But once started, these medications often must be taken for long periods.

“If left untreated, over time gout can lead to joint damage and deformities, a condition called chronic gout,” Choi notes. “In general, chronic gout arises only after many years of suffering.”

If you suffer from repeated bouts of joint pain and inflammation, talk to a health care provider. “If you have gout, the earlier you get diagnosed and undergo treatment – in addition to making healthy lifestyle changes – the better off you will be,” Choi notes.

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