Gout is a type of arthritis that can occur suddenly with a great deal of pain. It is both common and complex and can affect anyone. It’s characterized by severe attacks of pain, swelling, redness and tenderness in the joints, often the joint at the base of the big toe.
An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and tender. Gout symptoms may come and go, but there are ways to manage symptoms and prevent flares.
Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood. Other foods also promote higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose).
Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes either your body produces too much uric acid, or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needlelike urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.
- Intense joint pain.Gout usually affects the large joint of your big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins.
- Lingering discomfort.After the most severe pain subsides, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.
- Inflammation and redness.The affected joint or joints become swollen, tender, warm and red.
- Limited range of motion.As gout progresses, you may not be able to move your joints normally.
Tests to diagnose gout may include:
- Joint fluid test. Your doctor may use a needle to draw fluid from your affected joint. …
- Blood test. Your doctor may recommend a blood test to measure the levels of uric acid and creatinine in your blood. …
- X-ray imaging. …
- Dual energy CT scan.
If you experience sudden, intense pain in a joint, call your doctor. Gout that goes untreated can lead to worsening pain and joint damage. Seek medical care immediately if you have a fever and a joint is hot and inflamed, which can be a sign of infection.
You’re more likely to develop gout if you have high levels of uric acid in your body. Factors that increase the uric acid level in your body include:
- Eating a diet rich in meat and seafood and drinking beverages sweetened with fruit sugar (fructose) increase levels of uric acid, which increase your risk of gout. Alcohol consumption, especially of beer, also increases the risk of gout.
- If you’re overweight, your body produces more uric acid and your kidneys have a more difficult time eliminating uric acid.
- Medical conditions.Certain diseases and conditions increase your risk of gout. These include untreated high blood pressure and chronic conditions such as diabetes, metabolic syndrome, and heart and kidney diseases.
- Certain medications.The use of thiazide diuretics — commonly used to treat hypertension — and low-dose aspirin also can increase uric acid levels. So can the use of anti-rejection drugs prescribed for people who have undergone an organ transplant.
- Family history of gout.If other members of your family have had gout, you’re more likely to develop the disease.
- Age and sex.Gout occurs more often in men, primarily because women tend to have lower uric acid levels. After menopause, however, women’s uric acid levels approach those of men. Men are also more likely to develop gout earlier — usually between the ages of 30 and 50 — whereas women generally develop signs and symptoms after menopause.
- Recent surgery or trauma.Experiencing recent surgery or trauma has been associated with an increased risk of developing a gout attack.
During symptom-free periods, these dietary guidelines may help protect against future gout attacks:
- Drink plenty of fluids.
- Limit or avoid alcohol.
- Get your protein from low-fat dairy products.
- Limit your intake of meat, fish and poultry.
- Maintain a desirable body weight.
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- 22 Aug 2018
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