Gout: Symptoms, Causes and Treatment

Gout is a complicated kind of arthritis that causes sudden, acute pain, swelling, redness, and tenderness in one or more joints, most commonly the big toe.

Gout attacks can strike without warning, waking up in the middle of the night with the big toe in pain and having a burning sensation. Even the weight of the bedsheet on the affected joint may feel uncomfortable because it becomes swollen, and sensitive.

Gout symptoms

Gout symptoms and indicators nearly typically strike unexpectedly, and frequently at night. They are as follows:

Joint discomfort: Gout is most commonly associated with the big toe, but it can affect any joint. Ankles, knees, elbows, wrists, and fingers are among the other joints that are typically afflicted. The pain will most likely be the worst during the first four to twelve hours after it starts.
Discomfort that is continuous: Some joint discomfort may remain from a few days to a few weeks after the most acute pain has subsided. Attacks in the future are more likely to continue longer and damage more joints.
Inflammation and redness: Swollen, sensitive, heated, and redness develop in the afflicted joint or joints.
Restricted range of motion: Restricted range of motion You may not be able to move your joints normally as gout worsens
Swelling: The affected joint becomes swollen and appears red or purplish.
Intense Tenderness: The joint feels extremely tender to the touch, making it painful to move.
Warmth: The inflamed joint may feel warm or hot.
Redness: The skin around the affected joint may appear red or inflamed.

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When to see a doctor?

Visit a doctor if you get sudden, severe pain in a joint. Untreated gout can lead to increased discomfort and joint damage. If you have a fever and a heated and inflamed joint, this could be an indication of infection. Seek medical help right once. Get the best treatment for Gout at Medicover Hospitals from the top orthopedists

Causes of Gout

Some Causes of Gout are:

Uric Acid Buildup: Excess uric acid in the bloodstream can form sharp crystals in the joints, leading to inflammation.
Kidney Dysfunction: When the kidneys cannot excrete enough uric acid, it builds up in the body.
Dietary Factors: Consuming foods rich in purines (e.g., red meat, shellfish, alcohol, and sugary drinks) can raise uric acid levels.
Genetics: A family history of gout increases the likelihood of developing the condition.
Obesity: Excess body weight can increase uric acid production and decrease kidney function in eliminating it.
Dehydration: Insufficient fluid intake can contribute to higher concentrations of uric acid in the blood.
Medical Conditions: Conditions like hypertension, diabetes, metabolic syndrome, and certain kidney diseases can increase the risk of gout.
Medications: Diuretics, aspirin, and other medications that affect uric acid levels in the body may trigger gout attacks.
Alcohol Consumption: Excessive alcohol, especially beer, can elevate uric acid levels and trigger gout attacks.
Trauma or Injury: Joint injuries can provoke a gout attack, especially if uric acid is already elevated.

Gout Risk factors

There are many factors that can add-up to the symptoms of gout and worsen it further.

Age: Gout is more common in middle-aged and older adults, particularly men.
Gender: Men are at a higher risk, as women generally experience gout after menopause due to lower uric acid levels.
Family History: A family history of gout increases the likelihood of developing the condition.
Obesity: Being overweight or obese increases uric acid production and decreases the ability to eliminate it.
Diet: High purine foods (e.g., red meat, shellfish, sugary drinks, and alcohol) can raise uric acid levels, increasing the risk of gout.
Dehydration: Insufficient fluid intake can lead to higher concentrations of uric acid in the body, increasing the risk of gout.
Chronic Kidney Disease: Reduced kidney function makes it harder to eliminate uric acid from the body, increasing gout risk.
Certain Medications: Diuretics (water pills), low-dose aspirin, and immunosuppressants can elevate uric acid levels, raising the risk of gout.
Health Conditions: Conditions like hypertension, type 2 diabetes, metabolic syndrome, and hyperlipidemia (high cholesterol) can increase gout risk.
Excessive Alcohol Consumption: Beer and hard liquor raise uric acid levels and can trigger gout attacks.
Trauma or Surgery: Joint trauma, surgery, or dehydration due to illness can increase the risk of a gout flare-up.

Complications of Gout

Joint Damage: Repeated gout attacks can lead to permanent damage to the affected joints, causing deformities and impaired function.
Tophi Formation: Uric acid crystals can accumulate under the skin in nodules called tophi, which are typically found around joints, ears, and elbows. These can be painful and unsightly.
Kidney Stones: High levels of uric acid can lead to the formation of kidney stones, causing severe pain and urinary tract issues.
Chronic Gout: Frequent gout attacks can lead to chronic gout, where inflammation and joint damage persist and worsen over time.
Heart Disease: Untreated gout may be linked to an increased risk of cardiovascular issues, such as high blood pressure, heart attack, or stroke.
Infection of the Joint: If gout causes joint inflammation or tophi, it can create a higher risk for joint infections, which may require surgical intervention.
Disability: In severe cases, ongoing joint inflammation and damage can lead to a reduced ability to perform everyday activities and a decrease in quality of life.

Diagnosis of Gout

Gout drugs are divided into two categories, each of which addresses a different issue. The first type helps to alleviate the pain and inflammation associated with gout attacks. The second type reduces the quantity of uric acid in your blood, which helps to prevent gout problems.

The frequency and intensity of your symptoms, as well as any other health issues you may have, will determine which drug is best for you.

Test for joint fluid: A needle may be used by your doctor to drain fluid from your damaged joint. When the fluid is viewed under a microscope, urea crystals may be visible
A blood test is required: A blood test to determine the amounts of uric acid in your blood may be recommended by your doctor. However, blood test results can be deceiving. Some people have high levels of uric acid but never get gout. And other people have gout symptoms but no abnormally high levels of uric acid in their blood.
X-ray: This test uses X-rays of the joints can help rule out alternative causes of joint inflammation.
Ultrasound:This technique detects urate crystals in joints or tophi using sound waves. Computerized tomography with dual energies (DECT). To visualize urate crystals in joints, this test combines X-ray pictures acquired from a variety of angles.

Treatment of Gout

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Used to reduce pain and inflammation during a gout attack.
Colchicine: Used to reduce inflammation and pain during an acute gout flare-up. It is most effective when taken early in the attack.
Corticosteroids: Prescribed when NSAIDs and colchicine are ineffective or if the patient can't tolerate them. Can be taken orally or injected directly into the joint.
Urate-Lowering Therapy (ULT): Allopurinol and febuxostat are used to lower uric acid levels in the blood, preventing future gout attacks and the formation of uric acid crystals.
Lifestyle Changes: Dietary Modifications: Limit foods high in purines (e.g., red meat, seafood) and alcohol consumption (especially beer).
Weight Management: Achieving a healthy weight reduces stress on joints and lowers uric acid levels.
Pegloticase: Used for severe cases, where other treatments fail, to break down uric acid crystals in the body.
Joint Aspiration: In some cases, excess uric acid crystals or joint fluid may be aspirated to relieve pain and prevent joint damage.

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Gout Dos and Don’ts

A person with gout has to follow sets of do’s and don’ts to manage gout and related symptoms.

Do’s	Don’ts
Do’s	Don’ts
Drink plenty of water	Put too much pressure on the affected foot
Maintain a healthy weight	Stay sedentary with the fear of pain, keep moving
Take proper sleep of 8 hours	Leave your gout symptoms untreated
Avoid foods that might trigger a gout flare-up	Take over-the-counter medications frequently, it can increase the flare-up
Take prescription gout medication	Take too much stress.

A person with gout has to follow sets of do’s and don’ts to manage gout and related symptoms.

Do’s	Don’ts
Drink water	Drink beer
Drink milk	Drink liquor
Drink coffee	Drink soft drinks
Eat citrus	Eat organ meats
Eat vegetable proteins	Eat certain seafood

Prevention of Gout

Here are ways to prevent gout:

Maintain a Healthy Weight: Achieving and maintaining an optimal weight helps lower uric acid levels and reduces stress on weight-bearing joints.
Limit Alcohol Consumption: Avoid excessive drinking, especially beer and hard liquor, as alcohol can increase uric acid levels in the blood.
Avoid Purine-Rich Foods: Limit foods high in purines, such as red meat, organ meats, shellfish, and sugary drinks, which can raise uric acid levels.
Stay Hydrated: Drink plenty of water to help flush out uric acid and prevent dehydration, which can trigger gout attacks.
Exercise Regularly: Engage in moderate exercise (e.g., walking, swimming) to promote joint health and maintain a healthy weight. Avoid overexertion or injury.
Control Underlying Health Conditions: Manage conditions like high blood pressure, diabetes, and high cholesterol, which increase the risk of gout.
Limit Stress on Joints: Avoid joint injury by using proper techniques when lifting heavy objects and using protective gear during physical activities.
Monitor Uric Acid Levels: Regularly check uric acid levels through blood tests, especially for those with a history of gout or high uric acid levels.

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Frequently Asked Questions

Is there a specific diet for gout?

Yes, avoiding purine-rich foods like red meat, shellfish, and organ meats, and reducing alcohol intake, particularly beer, can help manage uric acid levels. Increasing water intake and consuming low-fat dairy, fruits, and vegetables can also be beneficial.

Can gout affect other joints?

Although gout often starts in the big toe, it can affect other joints like the ankles, knees, elbows, and wrists. Repeated attacks can lead to chronic joint problems and deformities.

Can stress cause a gout attack?

Stress itself may not directly cause gout, but it can lead to behaviors (like poor eating habits or alcohol consumption) that trigger a gout attack. Additionally, physical stress on the body can elevate uric acid levels.

Does gout affect women?

Gout is more common in men but can also affect women, especially after menopause when uric acid levels can rise. Women are generally diagnosed with gout at a later age compared to men.

Can gout be treated naturally?

In addition to medical treatments, some natural remedies like cherry juice, vitamin C, and a diet rich in anti-inflammatory foods may help manage gout. However, it's important to consult a healthcare provider for a comprehensive treatment plan.

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