All your questions about gout, asked & answered
Written by Sarah Thebarge, Physician Assistant
Gout is the leading cause of joint inflammation in the world, and rates of gout in the U.S. have more than doubled since the 1960s. The increases are due, in part, to the rise in obesity rates and increased incidences of hypertension (high blood pressure). Here are our answers to the most common questions patients ask us about gout.
1) What is Gout?
Gout is a form of arthritis that occurs when needle-shaped uric acid crystals deposit in a joint, causing pain, redness, warmth, and swelling. While gout can affect several joints, including the ankles, knees, elbows, and wrists, the most common site is the first metatarsal-phalangeal joint (MTP), where the big toe connects to the foot. The reason gout is more likely to affect this joint than others is because urate crystallizes into uric acid crystals at cooler temperatures. Since the big toe is farthest from the heart, it is often cooler than the rest of the body, making gout more likely to occur.
2) How is Gout Diagnosed?
Many cases of gout are diagnosed on history and exam. Patients who experience a sudden onset of redness, swelling, and pain along the great toe are often considered to have gout until proven otherwise. If the diagnosis is unclear, patients can have blood work done to evaluate their uric acid levels. Also, fluid can be aspirated from the affected joint and examined under the microscope for the presence of uric acid crystals. Imaging, such as X-rays and CT scans, can also be used to confirm the diagnosis.
3) How Common is Gout?
Gout affects more than 8 million Americans each year, meaning about 4% of the population receives this diagnosis every year.
4) What are The Risk Factors for Developing Gout?
Obesity, hypertension, diabetes, kidney disease, joint trauma, male gender, and age are all risk factors for developing gout. Patients who eat a diet high in purines (a compound that the body converts to uric acid), are also more likely to develop gout. Red meat, seafood, organ meats, and alcoholic beverages all contain high levels of purines.
5) Can Gout Be Prevented?
There are several steps patients can take to lower their risk of developing gout. Maintaining a healthy body weight, treating hypertension, managing diabetes, and eating a low-purine diet are all steps patients can take to lower their risk. Also, patients whose bodies over-produce uric acid are often prescribed an oral medication to take daily that lowers their uric acid level and helps prevent gout flare-ups.
6) How is Gout Treated?
Several medications are available to treat gout flares, including oral steroids, non-steroidal anti-inflammatory drugs (NSAIDs), and Colchicine, a medicine that decreases the severity of gout flare-ups. Other treatment options, such as prescription pain medication and cool compresses, can also be used to control patients’ symptoms.
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Sources: https://www.cdc.gov/arthritis/basics/gout.html
https://www.mayoclinic.org/diseases-conditions/gout/symptoms-causes/syc-20372897
https://my.clevelandclinic.org/health/diseases/4755-gout
https://www.foothealthfacts.org/conditions/gout
