Gout is a metabolic condition which causes inflammation in the joints. One of the key symptoms of the disorder is painful swelling in the joint of the big toe. However, it can affect the joints in the ankles, knees, elbows, wrists, and knuckles. According to a 2017 study in the Journal of Advanced Research, the prevalence of gout is around 1–4% and it may rise up to 10% in men and around 6% in women as they reach 80 years of age. It is quite common in men than in women. Moreover, the incidence of gout can increase due to poor dietary habits, lack of exercise, obesity and metabolic syndrome. Read to know more about the common causes, risk factors, symptoms, and treatment of gout.
What Causes Gout?
Gout is caused due to excess accumulation of uric acid in the body, a condition known as hyperuricemia. Uric acid (UA) is a compound which is produced when the purines (which constitute the cell and are also found in foods) are broken down. It occurs as a part of the normal mechanism to excrete urine from the body. UA is transported to the kidneys via blood and is eliminated from the body in the form of urine.
However, in some cases, there is an accumulation of uric acid, which could be due to excess production of uric acid or improper functioning of the kidneys. If the kidneys fail to process uric acid effectively, it causes an excess build up of the uric acid, which in turn causes gout. It is reported that only 10% of the cases of gout are caused due to increased production of uric acid, the remaining 90% is due to the under excretion by the kidneys.
According to the American Arthritis Foundation, there are certain factors that can trigger a gout attack and if you are already suffering from the condition, these factors can make it worse.
-Eating foods high in purines such as red meat and seafood
-Beverages loaded with high fructose corn syrup
-Drinking too much of alcohol
-Crash diets and fasting
-Certain medications such as diuretics and those used to treat swelling and heart failure
-Infection of the kidneys or the urinary bladder
What Are The Signs And Symptoms Of Gout?
In some cases, people suffering from gout are asymptomatic which means they do not show symptoms even if they have elevated levels of uric acid in the blood. This type of gout might not require any treatment. However, in some cases, the person might show symptoms which are acute or chronic.
Acute gout symptoms: If suffering from acute gout, symptoms appear suddenly and usually last for a short period of time. However, for people with chronic gout, the symptoms might last for a long time. Acute gout is characterized by:
-Rapid onset of pain in the joints
-Warmth in the affected area
-Swelling at the sight of accumulation of uric acid
-Tenderness (pain on touching/pressing) at the affected area
In most cases, the joint at the base of the big toe is the most common site for an attack. However, other joints are also affected which include the ankles, knees, writs, fingers, and elbows. The symptoms of acute gout might subside within hours or a few days with or without medications. In rare cases, it might last up to a few weeks.
Chronic gout symptoms: If suffering from chronic gout, it can lead to repeated attacks of gout over a long time which can even lead to permanent damage to the joints. In addition to pain, inflammation, swelling, and redness, it can also cause symptoms such as:
-Reduced mobility of the joints.
-Itchiness of the skin around the affected area
-Peeling of the skin around the affected area
Consult a doctor if you experience a sharp, shooting pain in a joint which fails to subside in a week or any gout symptoms. Gout if left untreated can cause joint erosion. The other serious health complications that might occur include deposition of urate crystals under the skin (tophi), inflammation of the tissue sac known as bursa that protects the tissues (bursitis) and kidney damage due to the buildup of urate crystals in the kidneys.
How Is Gout Treated?
Once your doctor diagnosis gout, which is done with a simple blood test to check the level of uric acid in the blood or by taking fluid from the affected joint, your doctor might prescribe medications. The medications for gout are aimed at blocking the production of uric acid and removing excess uric acid from the body along with reducing inflammation and pain in the joints. Medications such as nonsteroidal anti-inflammatory drugs, corticosteroids, and colchicine may be prescribed by your doctor based on clinical requirements and medical evaluation.
In addition to this, your doctor might recommend a few lifestyle changes to ease your gout symptoms and prevent future gout attacks. This includes limiting the intake of alcohol, beverages that contain high fructose corn syrup and foods rich in purines such as seafood. Additionally, increase the intake of water and lose weight (if you are overweight or obese) to maintain uric acid levels under control.
(The article is reviewed by Dr. Lalit Kanodia, General Physician)
1. Ragab G, Elshahaly M, Bardin T. Gout: An old disease in new perspective – A review. J Adv Res. 2017 Sep;8(5):495-511.
2. Gout. American Arthritis Foundation.
3. Informed Health Online. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006. Gout: Overview. 2015 Mar 11 [Updated 2018 May 17].
4. Hainer BL, Matheson E, Wilkes RT. Diagnosis, treatment, and prevention of gout. Am Fam Physician. 2014 Dec 15;90(12):831-6.
5. McGill NW. The epidemiology and treatment of gout. Open Access Rheumatol. 2011 Dec 20;3:73-82.