Overview
Gout is a type of arthritis caused by high uric acid levels, leading to painful joint inflammation. Symptoms include intense pain, redness, and swelling. It develops due to factors like high-purine diets, genetics, and medical conditions. Treatment involves gout medication, lifestyle changes, and dietary adjustments to manage symptoms and prevent flares.
What is Gout?
Gout is a type of arthritis caused by a buildup of uric acid in the blood, leading to the formation of sharp crystals in the joints. It usually presents in the foot, particularly the big toe, a symptom known as podagra. Though gout typically presents in the feet, it can also impact other joints.
Signs of gout include sudden and severe pain, swelling, and redness. Though it is a life-long condition, it can be easily managed with medication and with lifestyle changes.
What Are The Symptoms of Gout?
Gout symptoms are primarily felt during an attack and include:
- Intense pain, typically in one joint.
- Stiffness and swelling make it uncomfortable for the joint to move.
- Tenderness, where even the lightest touch causes extreme discomfort.
- Warmth, with the joint feeling unusually hot.
These symptoms often develop rapidly, peak within 24 hours, and can last days to weeks, leaving lingering soreness after the attack subsides.
What Does Gout Look Like?
Visually, gout is striking and hard to miss. The affected joint often appears:
- Red or purplish, sometimes resembling an infection.
- Swollen and shiny, as inflammation stretches the skin.
In chronic cases, tophi, or hard lumps caused by uric acid deposits, may form under the skin. This dramatic appearance, especially in the big toe, is a hallmark of gout and distinguishes it from the gradual swelling or stiffness seen in other forms of arthritis.
What Causes Gout?
Gout is caused by an accumulation of uric acid in the blood, a condition known as hyperuricemia. Serum urate levels, which measure the amount of uric acid in the blood, become elevated when the body produces too much uric acid or fails to eliminate it effectively.
Uric acid forms when the body breaks down purines, substances found naturally in the body and certain foods. When these levels become too high, uric acid can crystallise and deposit in the joints, triggering intense pain and inflammation.
Several factors that can contribute to the development of gout include:
- Dietary habits: Foods high in purines, such as red meat, seafood, and alcohol (especially beer), increase uric acid levels.
- Medical conditions: Kidney disease, obesity, and high blood pressure reduce the body’s ability to eliminate uric acid.
- Genetics: A family history of gout can increase the likelihood of a gout diagnosis.
- Medications: Diuretics and certain types of gout medication can alter uric acid levels and raise the risk.
How is Gout Diagnosed?
Diagnosing gout typically involves a combination of a consultation, lab tests, and potentially some imaging to confirm it.
First, your doctor or rheumatologist will ask for your medical history and discuss any symptoms. Then they will examine the affected joint and, they suspect you could have gout, there are a few tests they may request to confirm diagnosis:
- Joint fluid analysis: This is the most definitive test, where fluid is drawn from the affected joint and examined under a microscope to identify uric acid crystals.
- Blood tests: Used to measure your blood uric acid levels to check for hyperuricemia, though elevated levels alone do not confirm gout.
- Imaging scans: Ultrasound can detect uric acid crystal deposits. X-rays or CT scans may help rule out other causes of joint pain and visualise advanced damage or tophi deposits.
- Dual-energy CT (DECT): This specialised imaging can accurately pinpoint and map uric acid crystal deposits.
What Treatments Are There For Gout?
Treating gout may include a combination of medical treatments and lifestyle changes to relieve symptoms, prevent future attacks, and manage underlying causes. Here’s a breakdown of effective approaches for treating your gout.
Medical Treatments
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- Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin are commonly prescribed to reduce pain and inflammation during a gout flare.
- Colchicine: This medication is particularly effective in managing acute gout attacks by reducing inflammation caused by uric acid crystals.
- Corticosteroids: Administered orally or via injection, corticosteroids help control severe pain and swelling in cases where other medications are unsuitable. These are advised where NSAIDs are not effective.
- Urate-lowering therapies (ULTs): These long-term treatments, such as allopurinol or febuxostat, lower serum urate levels to prevent crystal formation and reduce the frequency of attacks.
Lifestyle Changes
- Gout diet: Adopting a diet low in purines (naturally occurring substances) can help reduce uric acid levels.
- Hydration: Drinking plenty of water supports kidney function and helps flush uric acid from the body.
- Weight management: Maintaining a healthy weight reduces stress on joints and helps lower uric acid production.
- Regular movement: Moderate, low-impact exercise like walking or swimming can help maintain joint function and reduce the risk of attack.
Living With Gout
Managing gout requires a proactive approach to prevent flares, reduce pain during attacks, and minimise long-term joint damage. By combining healthy habits, gout medication, and an understanding of what might trigger your flare-ups, you can live well with this condition.
Managing Flares (or Attacks)
During a gout attack, the primary focus is on reducing pain and inflammation:
- Rest the affected joint: Avoid putting weight on it and keep it elevated to reduce swelling.
- Apply cold packs: Ice packs for 15-20 minutes can help numb pain and decrease inflammation.
- Take prescribed medications: Medications like NSAIDs, colchicine, or corticosteroids can provide rapid relief.
- Stay hydrated: Drinking water supports uric acid elimination and may reduce the duration of an attack.
Avoiding Triggering Foods
Diet plays a significant role in managing gout, as certain foods can elevate uric acid levels and increase the risk of flares.
Foods to limit or avoid:
- High-purine foods: Red meat, organ meats (like liver), and certain seafood (such as shellfish, anchovies, and sardines).
- Alcohol: Beer and spirits, in particular, should be limited as they can impair the body’s ability to eliminate uric acid.
- Sugary drinks and foods: Sweetened beverages and processed snacks may increase the risk of flares.
Foods to include:
- Low-purine options: Whole grains, fruits, vegetables, and plant-based proteins (like tofu) are excellent alternatives.
- Low-fat dairy: Milk and yoghurt can help lower serum urate levels and reduce the frequency of attacks.
- Cherries: Some studies suggest cherries may have anti-inflammatory properties that benefit gout management.
When to Seek Medical Help
While mild gout symptoms may resolve on their own, if you experience the following symptoms, you should see your doctor to help prevent your gout from worsening.
- The pain becomes severe and unmanageable.
- Symptoms, like swelling, redness, or tenderness, last longer than a typical gout attack length (a few days to a week).
- Flares become more frequent.
- There are signs of infection, including extreme redness, fever, or pus around the joint are present.
- Hard lumps under the skin (tophi) appear.
Ignoring gout symptoms or delaying treatment can lead to permanent joint damage, chronic pain, and more severe conditions, such as kidney stones or kidney disease. If you’re concerned about any gout symptoms you’re experiencing, talk with your rheumatologist for advice.
Why Go Private with Mid Ulster Clinic For Gout Treatment?
Choosing to address your gout symptoms privately with us means you get:
- Prompt Access to Specialists: Avoid long waiting times with timely consultations from experienced rheumatologists for quicker diagnosis and treatment.
- Personalised Care: Receive a management plan tailored to your unique medical history and lifestyle for more effective outcomes.
- Advanced Diagnostic Services: Benefit from state-of-the-art tests, including blood diagnostics and imaging.
- Holistic Management Plans: Get comprehensive guidance, from adopting dietary advice to medical treatments that prevent and manage flares.
Book with us today for a rheumatologist consultation, or contact us if you have any queries.
- Medically Reviewed
