What Is Gout? Symptoms, Causes, Treatment, Medication, Diet, Remedies

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• Related Health Topics
• Wake Forest Baptist Health Managed Care
• What Are Risk Factors For Pseudogout?

If one has been diagnosed with gout and has had more than one attack of arthritis, take the medication prescribed by a physician for these attacks. The individual should be seen by a physician, in the emergency department, or urgent care center if the attack does not respond to this treatment. The individual may need regular medications to prevent further arthritis flares.

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Gout is a condition characterized by the deposition of monosodium urate crystals in the joints or soft tissue. The four phases of gout include asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout and chronic tophaceous gout. The peak incidence occurs in patients 30 to 50 years old, and the condition is much more common in men than in women. Patients with asymptomatic hyperuricemia do not require treatment, but efforts should be made to lower their urate levels by encouraging them to make changes in diet or lifestyle. Acute gout most commonly affects the first metatarsal joint of the foot, but other joints are also commonly involved. Definitive diagnosis requires joint aspiration with demonstration of birefringent crystals in the synovial fluid under a polarized light microscope.

Therefore, health care providers should test for these related health problems. Researchers are studying whether lowering blood uric acid levels can help heart disease and kidney disease. Some other kinds of arthritis can mimic gout, so proper diagnosis is key.

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Certain carbohydrates, such as oatmeal, wheat germ, and bran have moderate purine content but have not been shown to be significant gout risk factors. For those interested in achieving the maximal lowering of uric acid by dietary means, two “Gout Haters Cookbooks” are listed in the “Books about Gout” section below. There are a number of measures that can help resolve an attack of gout. See Table 2 for summary of treatment strategies for acute gout.

Your doctor may drain fluid from your joint to relieve your symptoms. Lose weight.For people who are overweight or obese, losing weight reduces pressure on joints, particularly weight bearing joints like the hips and knees. Reaching or maintaining a healthy weight can relieve pain, improve function, and slow the progression of arthritis.

If other members of your family have had gout, you are at greater risk for the disease. Located throughout the body, these thin, slippery sacs with just a slight amount of fluid in them act as cushions between bones and soft tissues. The bursae most commonly inflamed from gout are the boney tip of the elbow and the front of the kneecap . However, it can affect small joints like those in the finger, as well as large joints, such as the knee and hip. We’re one of the world’s top academic medical centers, with a unique legacy of innovation in patient care and scientific discovery. The Rheumatology Program at UT Southwestern Medical Center is recognized as among the best in the country for rheumatic diseases including crystalline arthropathies.

In addition, you may develop nodules of uric acid in the soft tissue around your joints. These are known as tophi and are most common on the fingers, elbows, and toes. Treatment with nonsteroidal anti-inflammatory drugs , glucocorticoids, or colchicine improves symptoms. Once the acute attack subsides, levels of uric acid can be lowered via lifestyle changes and in those with frequent attacks, allopurinol or probenecid provides long-term prevention. Taking vitamin C and eating a diet high in low-fat dairy products may be preventive.

Can drinking water flush out uric acid?

DO: Drink Water
And if you're having a flare, increase your intake to 16 glasses a day! The water helps to flush uric acid from your system.

In a 2014 study, having one to two drinks a day increased a person’s risk of a gout attack by 36%; having two to four drinks a day increased a person’s risk by 51%. Foods that are high in purines–a compound that, when broken down in the body, produces uric acid–can also trigger a gout attack. Some offenders include shellfish, red meats, and sugary drinks. According to a 2012 study, people with gout who ate the most purine-rich foods were almost five times as likely to have an attack than those who ate the lowest amount of purine-rich foods. The Boston University researchers also found that the impact from animal products were much larger than that of plant products.

Additionally, many people with pseudogout develop painful bone spurs on their joints. Joints can become visually swollen and deformed, and may become permanently stiff. Pseudogout pain is often less severe than pain associated with regular gout, but many individuals find it still interferes with their lives. The condition gets its name from its similarities to gout, though each condition is characterized by deposits of different crystals in the joints.

Can dehydration cause pseudogout?

Acute attacks of the arthritis of pseudogout can be caused by dehydration. This is particularly common in hospitalized patients and those recovering from operations, especially when associated with dehydration. Pseudogout can also be caused by the hormonal effects on calcium metabolism from hyperparathyroidism.

Learn more about physical activity for arthritis.Go to effective physical activity programs. Classes take place at local Ys, parks, and community centers. Learn more about CDC-recommended physical activity programs. Nonsteroidal anti-inflammatory drugs , especially if colchicine cannot be prescribed, are used to treat CPPD attacks.

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Like gout, pseudogout attacks can recur from time to time in the same joint or in different joints. The initial attack may last a few days to a few weeks unless it is treated. Unlike with gout, which is linked to excessive alcohol consumption and a diet high in seafood and organ meats, pseudogout attacks are not linked to certain foods in your diet. Like gout, pseudogout occurs more frequently in people over age 60.

People with insufficient kidney function are at increased risk for gout. Uric acid is generated as we metabolize the food we eat and as the body's tissues are broken down during normal cell turnover. A change of diet or weight loss might also be recommended. In short, gout is a very treatable disease as long as symptoms are recognized and appropriate evaluation and medical management are provided. "The type of medication prescribed depends on your symptoms, your overall health and your tolerance of side effects," says Everakes.

Urate crystals can form in people who have high levels of uric acid in the blood. This can happen when the body produces too much uric acid or the kidneys cannot remove enough. Crystalline arthropathies are a group of joint disorders caused by deposits of crystals in joints and the soft tissues around them.

If these medications are in chronic use at the time of an attack, it is recommended that they be continued. Levels that cannot be brought below 6.0 mg/dl while attacks continue indicates refractory gout. Hyperuricemia is a classic feature of gout, but nearly half of the time gout occurs without hyperuricemia and most people with raised uric acid levels never develop gout. Thus, the diagnostic utility of measuring uric acid levels is limited.