GOUT

Gout is a form of arthritis that affects the joints. In gout, there is too much uric acid in the body. When there is too much uric acid in the body, it can form crystals in one or more joints. The crystals irritate the joint and cause sudden pain, swelling, redness, and warmth. These symptoms are almost always acute and the attacks usually begin suddenly, without warning in the big toe at night after a person has been asleep for a while.

Gout attacks occur when the body makes too much uric acid or does not get rid of enough by passing it through the kidneys and into the urine. Uric acid levels in men start to go up after puberty. Women's uric acid levels usually do not go up until after menopause. For this reason women are protected from gout until several years after menopause. The uric acid levels have to be high many years before gout develops. Men with gout will have their first attack when they are middle aged.

Other causes of gout may include medications, trauma, too much alcohol, surgery, eating too much, bleeding, or infection. Some conditions may contribute to gout, including obesity, diabetes, high triglycerides, high blood pressure, thyroid problems, pregnancy, or a serious illness.

If a fever exists and a joint is hot and inflamed, seek immediate medical care since this could be a sign of infection. Seek medical advice when sudden intense pain occurs, even if it goes away in 1 or 2 days or if you have had gout diagnosed and have another attack. Screening tests may include urine and blood tests and a sample of fluid taken from the joint to look for crystals under a microscope. X-rays may be taken to check for changes to the joints if there have been other gout attacks.

Gout attacks should be treated immediately with rest and medication. For this, the provider may order non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen or naproxen. Aspirin is not usually ordered because it may keep the urine from taking the uric acid out of the body. NSAIDs should be taken with food or milk to prevent stomach upset. NSAIDs should not be taken by anyone who has been diagnosed with asthma, ulcer disease, or a bleeding disorder. Taking NSAIDs increases the risk of bleeding with trauma, dental work, surgery or if taking blood thinners (anticoagulants).

Other medications may also be used. They include colchicines or steroids. The sooner treatment is started, the sooner the symptoms stop, which may be within 24 to 48 hours. If gout is not treated, it could last a few days to several weeks.

A second attack may occur, but usually not for 6 months to 2 years, but it could be 20 years, or never. After the second attack, the provider will usually start the person on a medication to lower the uric acid level in the blood. There are several medications that may be used including allopurinol or probenecid. Colchicine may also be given with these to prevent more attacks.

The medications will have to be taken for life to prevent more attacks. If the medication is not taken, more attacks can occur and more often. After a while, the high uric acid levels in the blood may cause kidney stones or a form of disabling arthritis.

Some things that can be done to prevent gout attacks include: losing weight, drinking less alcohol, eating moderate amounts of protein, and a low fat diet. It is important to have a high liquid intake to help flush the uric acid out with the urine.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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