Caused by a buildup of uric acid in your body, gout is a type of arthritis. This chemical is created when your body breaks down purines, substances that are found in some foods and drinks, as well as within our bodies. Most of it dissolves in blood, moves to the kidneys and is eliminated in urine.
If your body makes too much uric acid or can’t excrete enough of it through urine, it can build up and form sharp crystals in your joints or surrounding tissue, causing gout, along with inflammation and pain that can be intense.
Gout has a long history, with descriptions as early as 5th century B.C. It used to be thought of as a disease affecting wealthy people, since it can be associated with rich foods and alcohol. However, it can affect anyone.
Who gets gout?
It’s estimated that over 8 million Americans have gout, based on a study reported by the Centers for Disease Control (CDC).1
It can often, but not always, occur after an illness or injury. Men are far more likely to be affected than women, but several years after menopause, women become just as likely to have it. You may also be more likely to have gout if you have a family member with the disease. Other medical conditions such as high blood pressure and diabetes also increase your risk of developing the disease.
What happens when you have gout?
The big toe is most commonly affected, although gout can affect other joints, including your hands, feet, elbows, and ankles.
When you first experience gout, it may get better in a few days. You may have another attack in 6-12 months. Over time, you may continue to experience flare ups that last longer and happen more frequently. It is important to see your physician after your first attack, as getting a handle on the disease can often avert its worsening over time.
Gout can become chronic, developing a condition known as gouty arthritis. This can affect several joints and eventually lead to joint damage and loss of motion.
Chronic gout over many years can also cause tophi to form. These are lumps or crystals that form under your skin and in joints and bone. They can cause even more pain and cause damage to nearby joints and bone.
Over time, gout can also cause kidney stones and other problems with your kidneys.
If you have an attack, it can last anywhere from a few days to two weeks. The disease can become chronic, with periods of no symptoms followed by flare-ups.
During a flare-up, you may experience the following:
- Intense pain and swelling in one or more joints that occurs suddenly, often at night.
- Discomfort that continues even after the most severe pain has lessened.
How is it diagnosed?
Gout is often suspected by your doctor if you have severe joint pain that came on suddenly. Your medical history, weight, and eating and drinking habits can also point toward gout. The only way to definitively diagnose gout, however, is by examining fluid from inside your joints under a microscope and finding uric acid crystals.
How is gout treated?
Once you’re diagnosed, your doctor will probably prescribe one or more medications. Often you’ll take one type to help alleviate the pain and inflammation associated with flare-ups. These may include nonsteroidal anti-inflammatory medicines. Your doctor may give you a corticosteroid injection to help treat the joint inflammation directly.
You also may take another type of medicine designed to keep uric acid from building up. Allopurinol is perhaps one of the most commonly used medicines for preventing gout flare ups. If it’s taken while you’re in the midst of an attack, it can actually make it worse, so it should be taken when you’re not experiencing symptoms. Check with your doctor to be sure.
You may also be asked to make some lifestyle changes. These may include:
- Losing weight if you need to do so
- Limiting foods that are high in purines, such as steak, organ meats like liver, and seafood
- Limiting the amount of alcohol you consume, especially beer
- Limiting your consumption of drinks sweetened with fructose, especially high fructose corn syrup, such as non-diet sodas
You may define gout by the pain it causes. Although it can’t be cured, it can often be effectively treated. It’s important to follow your doctor’s treatment plan to avoid painful flare ups in the short term as well as more serious side effects like tophi in the future.