Gout Symptoms, Causes, Treatments, And Relation To Kidney Disease

Content

• Daily Health News
• Myth: Gout Pain Always Attacks The Big Toe
• Strange Lumps And Bumps Around Your Joints
• What Else Should I Ask My Healthcare Provider About Gout?
• Who Is At Risk Of Gout?
• Explore Health Com

Order laboratory tests, take a sample of fluid from one of your painful joints, or order imaging tests. Rarely, younger people develop the disease; however, if they do, the disease tends to be worse. If you experience sudden, intense pain in a joint, call a healthcare provider right away. If the joint is hot and inflamed, you might have gout — or you might have another problem like an infection.

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Colchicine dose needs to be adjusted in patients with significantly decreased kidney function. Colchicine has interactions with certain other medications, most notably clarithromycin (Biaxin®). The prevalence of gout has increased in both older and younger people. The increase in younger people is not explained, but the increase in older people, at least in part, relates to increased life span, increased weight and increased use of diuretics. Diuretics are used commonly for hypertension, for example, and they elevate the blood levels of uric acid and can increase the risk of gout.

It is given by intravenous infusion every 2 weeks and is used primarily in people who have long-standing gout that has not been successfully treated with other therapies. As they gradually lose weight, their blood levels of uric acid often decrease but usually not enough to dissolve the uric acid deposits. Hard lumps of uric acid crystals are first deposited in the joint lining or cartilage or in bone near the joints and then under the skin around joints.

Myth: Gout Pain Always Attacks The Big Toe

The most reliable test for gout is detecting uric acid crystals in the joint fluid obtained by joint aspiration. This common office procedure is performed with topical local anesthesia. Using sterile technique, fluid is withdrawn from the inflamed joint with a syringe and needle. Untreated gout may cause deposits of urate crystals to form under the skin in nodules called tophi (TOE-fie).

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Sometimes a buildup can occur if too much uric acid is produced or the kidneys can’t properly dispose of it. Although gout can cause pain, it can be managed with proper treatment. If you don’t have a gout specialist, use this “Find a Gout Specialist” tool to identify healthcare professionals who are experienced treating chronic gout. If you think you might have gout, it is important to get tested and diagnosed by a doctor, so that you can get the treatment you need. Wikipedia's health care articles can be viewed offline with the Medical Wikipedia app.

Is gout a serious problem?

Gout is more than just painful flares. If not managed properly, over time gout can cause permanent joint destruction, bone erosion and kidney damage. With advances in treatments and understanding of the disease, gout is a manageable condition and flares can be controlled with the appropriate long-term management.

More than 8 million people in the United States have gout. Some people with severe chronic gout have only short breaks in between attacks and feel symptoms of gout most of the time. Arthritis is a common condition that causes swelling and pain in your joints. Gout is considered a chronic disease, meaning it does not have a cure and will usually last your whole life. Dutch scientist Antonie van Leeuwenhoek first described the microscopic appearance of urate crystals in 1679.

This is because anything that raises or lowers the uric acid level can cause a gout flare by causing uric acid crystals to deposit in a joint. The treatment of certain types of cancer can cause gout because of high levels of uric acid released when the cancer cells are destroyed. Degenerative arthritis also makes affected joints more likely to be the site of a gouty attack.

What Else Should I Ask My Healthcare Provider About Gout?

Many people with gout have a high level of uric acid in the blood. However, the uric acid level may be normal, especially during an acute flare-up. Many people have high levels of uric acid in the blood but do not have flare-ups of gout; therefore, a blood test alone is not sufficient for diagnosis. Avoid alcohol or only drink in extreme moderation if you have had gout attacks in the past. Alcohol affects the body's metabolism of uric acid and can cause it to build up .

What is the fastest way to get rid of uric acid crystals?

Too much alcohol may raise your uric acid level and bring on a gout episode. Drink at least 10-12 eight-ounce glasses of non-alcoholic fluids daily, especially if you have had kidney stones. This will help flush the uric acid crystals out of your body.

Staying well hydrated is the best way to prevent gout attacks. Proper hydration also decreases the risk of kidney stones or kidney dysfunction as a result of built-up uric acid. The three renal complications of gout are nephrolithiasis and acute and chronic gouty nephropathy.

Who Is At Risk Of Gout?

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During the periods between gout flares, patients often have no symptoms and feel totally fine. This pattern is highly suggestive of gout compared to many other types of arthritis. Gout is a condition in which uric acid accumulates in the blood stream and then in the joint spaces.

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Some of Hippocrates' remarkable clinical perceptions in relation to gout are preserved in aphorisms, which are as true today as they were 2500 years ago . Hippocrates also noted the link between the disease and an intemperate lifestyle, referring to podagra as an 'arthritis of the rich', as opposed to rheumatism, an arthritis of the poor. Six centuries later, Galen was the first to describe tophi, the crystallized monosodium urate deposits that can follow longstanding hyperuricemia.

The buildup of uric acid that led to your gout attack can still harm your joints. An orthopedic physician will help you get relief from the pain of gout attacks and learn ways to prevent flare-ups in the future. Biologically significant hyperuricemia occurs when serum urate levels exceed solubility (~6.8 mg/dL). Hyperuricemia is a common serum abnormality that does not always progress to gout. Humans generate about 250 to 750 mg of uric acid per day. The uric acid comes from dietary purines and the breakdown of dying tissues.

Guidelines also recommend uric acid-lowering treatment if a person with gout also has kidney disease. Colchicine (Colcrys®, Mitigare®) has a role in both the prevention and treatment of gout attacks . See details about colchicine for attacks of gout in Table 2. An attractive feature of colchicine is how specific it is. For example, it can resolve an attack of gout, but it doesn't help a flare-up of rheumatoid arthritis. If the level of colchicine builds up too high, as it might if a usual dose is given to a patient with severe kidney disease, toxicity can occur, such as suppression of the production of blood cells.

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Some experience pain so intense that even the light touch of a bed sheet on the joint is excruciating. These painful attacks can last from hours to several days. In cases of chronic inflammation, the attack may last for weeks.

Joint fluid test, in which the doctor uses a needle to draw a sample of fluid from the affected joint and evaluate it for uric acid crystals, which can be directly visualized using a microscope. Crystals may also be found under the skin in deposits known as tophi, which indicate advanced gout. Because the symptoms of gout can mimic those of other types of arthritis, an accurate diagnosis is a critical step toward finding effective gout treatment. Your primary care provider will likely refer you to a rheumatologist, a doctor who specializes in various types of arthritis, to make a gout diagnosis and discuss treatment options.