Gout is a complex form of arthritis, characterized by sudden, severe attacks of pain, swelling, redness and tenderness in the joints, which can affect anyone. It often affects the joint at the base of the big toe.
An attack of gout can occur abruptly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint becomes hot, swollen and tender, such that even the weight of the sheet on it would appear excruciating.
Gout symptoms may be intermittent, but there are ways to manage symptoms and prevent flares.
Symptoms of Gout
The signs and symptoms of gout almost always occur suddenly, and often at night. They include:
- Intense joint pain –Gout usually affects the large joint of your big toe, however, 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.
- Lingering discomfort –After the most severe pain decreases, some joint discomfort may last from a few days to a few weeks. Later attacks are likely to last longer and affect more joints.
- Inflammation and redness –The affected joint or joints become swollen, tender, warm and red.
- Limited range of motion.As gout progresses, you may find it difficult to move your joints normally.
Causes of Gout
Gout is caused by the accumulation of urate crystals in your joint, leading to 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).
Purines are also found in certain foods, such as organ meats, steak, and seafood. Other foods also promote higher levels of uric acid, such as alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose).
Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. Sometimes either your body produces too much uric acid or your kidneys excrete too little uric acid. When this happens, uric acid can accumulate, 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:
- Eating a diet rich in meat and seafood and drinking beverages sweetened with fruit sugar increase levels of uric acid, which increase your risk of gout. Drinking alcohol like beer also increases the risk of gout.
- If you’re overweight, your body produces more uric acid and your kidneys find it difficult to get rid of uric acid.
- Medical conditions –Certain diseases and conditions increase your risk of gout. These include untreated high blood pressure and chronic conditions such as diabetes, metabolic syndrome, and heart and kidney diseases.
- Age and sex –Gout affects more often in men, mainly because women appears to have lower uric acid levels. After menopause, however, women’s uric acid levels approach those of men. Men are also more likely to develop gout earlier, usually between the ages of 30 and 50 — whereas women generally develop signs and symptoms after menopause.
- Certain medications –The use of thiazide diuretics — commonly used to treat hypertension — and low-dose aspirin also can increase uric acid levels. So can the use of anti-rejection drugs prescribed for people who have undergone an organ transplant.
- Family history of gout –If other members of your family have had gout, you’re more likely to develop the disease.
- Recent surgery or trauma –Experiencing recent surgery or trauma has been associated with an increased risk of developing a gout attack.
People with gout can develop severe conditions, such as:
- Recurrent gout.Some people may never experience gout symptoms again, while others may experience gout several times yearly. Medications may help prevent gout attacks in people with persistent gout. Gout can cause erosion and destruction of a joint if left untreated.
- Advanced gout.Gout left untreated may cause deposits of urate crystals to form under the skin in nodules called tophi. Tophi can develop in several areas such as your hands, fingers, feet, elbows or Achilles tendons along the backs of your ankles. Tophi usually aren’t painful, but they can become swollen and tender during gout attacks.
- Kidney stones.Urate crystals may collect in the urinary tract of people with gout, causing kidney stones.
When to see a doctor
You need to contact your doctor if you experience sudden, intense pain in a joint. Untreated gout can lead to worsening pain and damage to joints. Seek medical care instantly if you have a fever and a joint is hot and inflamed, which can be a sign of infection.
- Drink lots of fluids.Drink plenty of fluids, especially water to remain hydrated. Reduce your intake of many sweetened beverages you drink, especially those sweetened with high-fructose corn syrup.
- Limit or avoid alcohol.Talk with your doctor about whether any amount or type of alcohol is safe for you. Recent evidence suggests that beer may be particularly likely to increase the risk of gout symptoms, especially in men.
- Get your protein from low-fat dairy products.Low-fat dairy products may truly have a shielding effect against gout, so these are your best-bet protein sources.
- Limit your intake of fish, meat, and poultry.A small amount may be tolerable, but pay close attention to what types and how much appears to cause problems for you.
- Maintain a healthy body weight.Eat healthy to maintain a healthy weight. Losing weight may decrease uric acid levels in your body. However avoid fasting or rapid weight loss, because it may briefly raise uric acid levels.