Gout Causes, Symptoms & Pain Treatment

Content

• Treating Gout Attacks
• Leading A Gout Free Life
• Try These Curated Collections
• The Role Of Uric Acid
• What Foods Should People With Gout Eliminate From Their Diet?
• How Is Gout Treated?

If levels of uric acid build up in your system, it can precipitate a gout attack in your joints. There is a risk for an acute gouty flare-up when prophylaxis is discontinued. However, most patients are able to remain on urate-lowering agents alone. If patients do not tolerate daily doses of colchicine, a low daily dose of a selected NSAID can be used instead.

Since it is hard to heal the skin after a tophus is removed, a skin graft may be needed. For this reason, we often try hard to manage the tophus medically. If we give high doses of medication to lower the urate level, such as allopurinol, over time the tophus will gradually reabsorb. In severe cases, we may consider using the intravenous medication pegloticase (Krystexxa®), since it lowers the urate level the most dramatically, and can lead to the fastest shrinkage of the tophus. Now that the FDA has put this warning on febuxostat, even in people with kidney abnormality we would be likely to start allopurinol first. For people already on febuxostat who never took allopurinol, it is an individual case decision about whether to switch to allopurinol.

Treating Gout Attacks

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider. Uric-acid-lowering medicine, such as losartan or allopurinol. The new gout guidelines recommend taking these with a three- to six-month course of NSAIDS.

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. The exact cause of gout is not yet known, although it may be linked to a genetic defect in purine metabolism. Uric acid, the most insoluble of the purine substances, is a trioxypurine containing three oxygen groups.

Leading A Gout Free Life

Gout is a form of arthritis, highlighted by sudden burning sensations, joint swelling, and stiffness. Gout is usually discovered because of its “attacks”—sudden burning and sharp pain that, when it recurs, can cause serious damage to joints, tendons, muscles, and other bodily tissues. Joints can also become extremely swollen and bulbous, which can make moving the joint in question difficult and painful. Many individuals learn to recognize when a gout flare up is imminent. The intense pain that is experienced in the midst of an attack is often preceded by burning, itching, or tingling in the affected joint. These signs can begin one to two hours before an attack.

Colchicine may interact with other commonly prescribed drugs, such as atorvastatin and erythromycin, among others. The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health. Malaika Hill is a freelance health writer specializing in ophthalmology and population health. Malaika can be found on her website mdwesolutions.com, LinkedIn @malaikadavid, or Twitter @malaika_hill.

If you have refractory gout, all of the above steps need to be taken to help reduce uric acid levels and symptoms related to gout. If symptoms continue despite treatment, then you may need to talk to your healthcare provider about your treatment plan, and what other changes to your diet and medicines might need to be made. A physical exam will check for signs and symptoms related to gout. The levels of uric acid will be checked in the blood and urine. Fluid from an affected joint might also be examined for gout crystals.

Can you see gout on an xray?

Plain film radiography may be used to evaluate gout; however, radiographic imaging findings generally do not appear until after at least 1 year of uncontrolled disease. The classic radiographic finding of gout late in disease is that of punched-out or rat-bite erosions with overhanging edges and sclerotic margins.

It is unclear whether dietary supplements have an effect in people with gout. If you’ve been diagnosed with gout, doctors can prescribe medications like allopurinol and lesinurad to help lower the levels of uric acid in the body, thereby warding off a future attack. And by avoiding foods that are high in purines, it’s possible to avoid a flare-up of gout symptoms. Other health problems that can boost your uric acid levels include high blood pressure, hypothyroidism, and psoriasis. Losing excess weight may help decrease uric acid levels in the body.

After treating the pain and inflammation of a gout flare up, it is important to decrease your uric acid levels to prevent future gout attacks and joint damage. Your rheumatologist will work with you to find a balance of medications and lifestyle changes to help lower your uric acid levels. Uric acid is a substance resulting from the breakdown of purines, which are proteins found in human tissues and in many foods. Gout is caused by elevated levels of uric acid in the blood, due to either increased production of uric acid or decreased excretion of uric acid by the kidney.

An evolutionary loss of urate oxidase , which breaks down uric acid, in humans and higher primates has made this condition common. Long-standing elevated uric acid levels may result in other symptoms, including hard, painless deposits of uric acid crystals known as tophi. Extensive tophi may lead to chronic arthritis due to bone erosion. Elevated levels of uric acid may also lead to crystals precipitating in the kidneys, resulting in stone formation and subsequent urate nephropathy.