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

Content

• Colchicine
• How Common Is It?
• Gout Attacks Can Cause Severe Joint Pain
• How Is A Gout Attack Treated?
• Signs And Symptoms Of Acute Gout

But for too many patients with gout, the disease goes untreated or undertreated. In one recent study, for example, only 37 percent of people with gout were taking the uric acid-lowering medication allopurinol; among gout patients with frequent flares, only half were taking it. Some people may never experience gout signs and symptoms again. Medications may help prevent gout attacks in people with recurrent gout. If left untreated, gout can cause erosion and destruction of a joint. Gout occurs more often in men, primarily because women tend to have lower uric acid levels.

What is the main cause of gout?

Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat.

The main goal of treating gout is to reduce the amount of urate in your blood. Joint crystals will not dissolve or go away unless the serum urate concentration is below six mg/dL. Ultrasonography can also show a ‘double contour sign.’ This sign looks like a top covering or extra coating of the joint surface when crystals are deposited in the hyaline cartilage. Ultrasonography, however, although very useful, should not replace fluid removal and examination in the diagnosis of gout because ultrasound cannot confirm infection. Please note, the information provided throughout this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and video, on or available through this website is for general information purposes only.

Colchicine

However, it can affect small joints like those in the finger, as well as large joints, such as the knee and hip. The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments. All products and services featured are selected by our editors. Health.com may receive compensation for some links to products and services on this website.

Usually, it passes through the kidneys and is shuttled out of the body through urine. But when too much uric acid builds up–or the kidneys can’t metabolize it quickly enough–it collects into crystals and settles into the joints. Gout is caused by the buildup of uric acid, which is formed after the body breaks down substances called purines.

How Common Is It?

Identifying uric acid crystals in joint fluid helps confirm a gout diagnosis. Gout occurs when urate crystals accumulate in 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. Microscopic tophi may be walled off by a ring of proteins, which blocks interaction of the crystals with cells and therefore avoids inflammation.

When excretion is insufficient to maintain serum urate levels below the saturation level of 6.8 mg/dL, hyperuricemia may develop, and urate can crystallize and deposit in soft tissues. Gout can be considered a disorder of metabolism that allows uric acid or urate to accumulate in blood and tissues. When tissues become supersaturated, the urate salts precipitate, forming monosodium urate crystals. In addition, the crystals also are less soluble under acid conditions and at low temperatures, such as occur in cool, peripheral joints .

Gout Remedies That Work

Eicosapentaenoic acid is known to reduce chronic inflammation. It has not yet been studied to see whether it can help reduce inflammation from gout. This medicine is for gout that has lasted a long time and hasn't responded to other treatment.

This refers to the time period between gout attacks where the patient is free of symptoms and joint function appears to be normal. However, the uric acid crystals continue to deposit in the joints and accumulate quietly, which eventually leads to another attack unless the uric acid level is reduced to below 6.0 mg/dL. A laboratory technician will look at the sample under a microscope to check the fluid for signs of gout or other conditions that can cause joint swelling, including infection and pseudogout.

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Low-dose aspirin and some medications used to control hypertension — including thiazide diuretics, angiotensin-converting enzyme inhibitors and beta blockers — also can increase uric acid levels. So can the use of anti-rejection drugs prescribed for people who have undergone an organ transplant. Gout is a common and complex form of arthritis that can affect anyone.

Related Health Topics

H&E stain, high power, showing that most urate crystals have been dissolved but that some pale brown-gray crystals did survive processing. Chronic tophaceous gout in untreated patient with end-stage renal disease. Gout is associated with considerable morbidity, with acute episodes often causing incapacitation. However, gout that is treated early and properly carries an excellent prognosis if patient adherence to treatment is good. Although genetic factors have been strongly associated with hyperuricemia, environmental and other state-of-health factors are responsible for the majority of the gout burden in developed countries. Therapy to control the underlying hyperuricemia generally is contraindicated until the acute attack is controlled .

What does gout pain feel like?

If you have gout, you'll probably feel swelling and pain in the joints of your foot, particularly your big toe. Sudden and intense pain, or gout attacks, can make it feel like your foot is on fire.

The large joint at the base of the big toe is the most common site for a gout attack, however, any other joint can be affected. Most commonly, other joints affected are the ankles, knees, wrists, fingers, and elbows. Since uric acid is filtered through the kidneys, the two diseases are related. Determination of 24-hour urine uric acid excretion is essential to identify the most appropriate urate-lowering medication and to check for significant preexisting renal insufficiency. Patients who have renal insufficiency or a history of nephrolithiasis, or those who might benefit from the cardioprotective effect of low-dose aspirin therapy should not take uricosuric agents. Medications such as nonsteroidal anti-inflammatory drugs , colchicine, and/or corticosteroids may be used.

What Is The Prognosis For Gout?

Subsequent attacks of podagra may last longer than the initial one. Once the acute phase is over, usually within 7-10 days, there is an intercritical asymptomatic period between acute flares 12. This asymptomatic period is unique to crystal arthropathies and varies in length between patients, but often lasts months 12. Wikipedia's health care articles can be viewed offline with the Medical Wikipedia app.

Gout is caused by having too much uric acid in your blood. Uric acid is made when your body breaks down chemicals called purines. However, if intravenous colchicine is used, the initial dosage is 1 to 2 mg in 20 mL of normal saline, infused over one hour into an established venous access.

In gout, excess uric acid causes needle-shaped crystals to form in the synovial fluid. Uric acid is a normal chemical in the blood that comes from the breakdown of other chemicals in the body tissues. As your immune system tries to get rid of the crystals in the synovial fluid, inflammation develops.

Urate crystals may collect in the urinary tracts of people with gout, causing kidney stones. Gout usually affects the big toe, but it can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it begins. People with gout will sometimes think that the prolonged absence of symptoms means that the disease has spontaneously disappeared. Unless the underlying cause of high uric acid levels is controlled, the disease can advance silently and reap irreversible harm.