Gout

Gout is a form of arthritis marked by sudden attacks of painful, inflamed joints. It is characterized by pain, swelling, redness, and warmth (inflammation) as well as stiffness in a joint or joints. Without treatment, gout attacks tend to recur and may cause severe damage to joints, tendons, and other tissues. Gout is most common in men.

What causes gout?
Gout is caused by too much uric acid in the blood (hyperuricemia). Hyperuricemia usually does no harm, and most people with high levels of uric acid in the blood never develop gout. When uric acid levels in the blood are too high, uric acid may form crystals that accumulate in the joints. The exact cause of hyperuricemia sometimes goes undiscovered, although inherited factors (genes) seem to play a role. Gout can seem to flare up without specific cause or can be brought on by factors such as being overweight, eating meats and seafood that are high in chemicals called purines, taking certain medications (especially aspirin and diuretics), and drinking too much alcohol.

What are the symptoms?
Gout usually develops after a number of years of buildup of uric acid crystals in the joints and surrounding tissues. The most common symptom of gout is a nighttime attack that produces swelling, tenderness, redness, and sharp pain affecting a big toe (this symptom is called podagra). People who have gout may have a few very painful attacks in one or two joints, usually the big toe, foot, ankle, or knee joints. The attack can last a few days or as long as several weeks, and then the symptoms disappear completely. Another attack may not occur for months or years.

How is gout diagnosed?
A physical examination and complete medical history will help you and your health professional identify the cause of your symptoms. While several tests can support a diagnosis, the joint fluid aspiration test, which checks for the presence of uric acid crystals in the joint fluid, is considered most helpful. Your health professional will probably also do a blood test to measure the uric acid content in your blood.

How is it treated?
The goals of treatment for gout are rapid pain relief and prevention of future gout attacks and long-term complications, such as joint destruction and kidney stones. There are two parts to the treatment of gout:

• Reducing acute painful joint inflammation (a gouty attack) by using anti-inflammatory medications or corticosteroids
• Preventing future attacks and long-term complications by:

Eliminating causes such as certain medications
• Adjusting diet and alcohol intake
• Taking prescribed medication to lower the uric acid

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