Gout is a complex form of arthritis characterized by sudden, severe attacks of pain, redness and tenderness in joints, often the joint at the base of the big toe.
Gout can affect anyone. Men are more likely to get gout, but women become increasingly susceptible to gout after menopause.
An acute attack of gout can wake you up in the middle of the night feeling like your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet on it seems intolerable.
Fortunately, gout is treatable, and there are ways to reduce the risk that gout will recur.
The signs and symptoms of gout are almost always acute, occurring suddenly — often at night — and without warning. They include:
When to see a doctor
Seek medical care immediately if you have a fever and a joint is hot and inflamed, which can be a sign of infection.
Gout causes intense pain and swelling around one or more joints. Gout most commonly affects the joint at the base of the big toe. ...
Gout occurs when urate crystals accumulate around 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. Your body produces uric acid when it breaks down purines — substances that are found naturally in your body — as well as in certain foods, such as organ meats, anchovies, herring, asparagus and mushrooms.
Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes your body either produces too much uric acid or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needle-like urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.
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:
People with gout can develop more-severe conditions, such as:
Preparing for your appointment
Make an appointment with your doctor if you have symptoms that are common to gout. After an initial examination, your doctor may refer you to a specialist in the diagnosis and treatment of arthritis and other inflammatory joint conditions (rheumatologist).
Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
Questions to ask the doctor at the initial appointment include:
Questions to ask if you are referred to a rheumatologist include:
If any additional questions occur to you during your medical appointments, don't hesitate to ask.
What to expect from your doctor
Tests and diagnosis
Tests to help diagnose gout may include:
Treatments and drugs
Treatment for gout usually involves medications. What medications you and your doctor choose will be based on your current health and your own preferences.
Different medications are prescribed to:
Drugs used to treat acute attacks and prevent future attacks include:
Drugs used to prevent the complications associated with frequent gout attacks include:
Lifestyle and home remedies
Medications are the most proven, effective way to treat gout symptoms. However, making certain changes to your diet also may help.
The American Dietetic Association recommends following these guidelines during a gout attack:
If gout treatments aren't working as well as you'd hoped, you may be interested in trying complementary and alternative treatments for your gout. Discuss these treatments with your doctor first. Your doctor can help you weigh the benefits and risks and tell you if the treatments will interfere with your gout medications.
Though you may be reluctant to discuss complementary and alternative medicine with your doctor, many mainstream doctors are becoming more open to discussing these options. But, since few of these treatments have been extensively studied in clinical trials, it's difficult to assess whether these treatments are helpful for gout pain. In some cases, the risks of these treatments aren't known.
Some complementary and alternative treatments that have been studied include:
Other complementary and alternative medicine treatments may help you cope until your gout pain subsides or your medications take effect. For instance, relaxation techniques, such as deep-breathing exercises and meditation, may help take your mind off your pain.
You usually begin taking preventive medications once your acute gout attack has subsided. Options include:
Last Updated: 2009-11-14
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