Gout is a type of inflammatory arthritis described by many as sudden and severe pain, redness, and swelling in the joints. Gout flares most commonly cause pain to the big toe, ankle, or knee where usually 1 joint is affected at a time, but some people may have pain in more than 1 joint.
Gout occurs from the accumulation of uric acid in the blood which can form sharp needle-like crystals that deposit into joints and cause pain. People with gout often experience sudden “flares” of severe pain, but there are medications to help counteract an acute event or even help prevent a future one from occurring.
Gout Risk Factors
Gout is most commonly found in adulthood and is very rare in children. It affects about 4% of adults in the United States. Hyperuricemia or elevated uric acid in the blood occurs when the body produces too much uric acid or the kidneys excrete too little.
Several medical conditions can increase hyperuricemia such as obesity, high blood pressure, chronic kidney disease, and excessive amounts of alcohol, red meat or seafood, or beverages containing high fructose corn syrup (non-diet sodas). Some medications that affect blood levels of urate such as diuretics may also be a risk factor for hyperuricemia.
Gout Diagnosis
Although there are many illnesses that can also cause joint pain, Gout is highly suspected if a person has one or more sudden attacks of joint pain followed by a period of no symptoms despite having an elevated blood level of urate.
To test for Gout, your doctor may ask to extract a sample of fluid from the affected joint to check for the presence of urate crystals. Some imaging procedures may also detect the presence of crystals in the joints.
Gout Treatment
Treatment of Gout is aimed at managing acute attacks and preventing future episodes from occurring.
The goal of treatment for Gout flares is to safely reduce inflammation and pain therefore treatment remains short-term and limited to the duration of flare. Medications for flares can include anti-inflammatory medications such as NSAIDs (e.g. Ibuprofen) and prescription medications. It is important to keep in mind that early treatment is key for minimizing the amount of time it takes to decrease pain and duration of flare.
The goal of preventative therapy in Goat is to prevent or reduce future gout flares by lowering urate levels and therefore preventing urate crystal deposits into joints. Some medications can help to prevent formation of urate, and others help by increasing the efficiency of urate excretion by the kidneys.
Because these are long-term therapies, it may take weeks or months to lower urate levels to a target goal which your provider will discuss and adjust medication doses to meet that goal.
Outside of medications, lifestyle changes may also reduce the frequency of gout flares. Because obesity is a risk factor, maintaining a healthy weight is an important consideration. Though dietary modifications alone may not lower blood urate levels, it is best to eat a well-balanced diet, drinking plenty of water to avoid dehydration, and limiting alcohol intake, sugary beverages and high-purine foods, such as red meat and seafood.
Conclusion
Though once nicknamed the “Disease of Kings,” due to it causes being a diet of “rich foods” and alcohol, Gout is a manageable medical condition with the use of proper medications and lifestyle adjustments. Early diagnosis and start of treatment are key elements to prevent longer duration of flares and further complications. If you experience symptoms of Gout, please consult your health care provider. Anyone can get treatment for Gout, not just kings, … or queens.
Dr. Tabula is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.
