Understanding Gout: Causes, Symptoms, and Management

Gout is a form of arthritis caused by excess uric acid buildup in the bloodstream, leading to the formation of sharp crystals in joints. It commonly affects the big toe but can also involve the ankles, knees, wrists, or elbows.

Sudden flare-ups produce intense pain, redness, and swelling, lasting from 3 to 10 days, with the worst pain typically in the first 36 hours. After the initial attack, episodes may be months or years apart.

Who is at Risk?
Men over 40 are more prone, with a ratio of 3:1 compared to women, who often develop gout post-menopause. Risk factors include obesity and alcohol consumption.

Family history of gout

Use of certain medications like diuretics or drugs for psoriasis/rheumatoid arthritis

High blood pressure, cardiovascular disease, diabetes, or high cholesterol

Gastric bypass surgery

Causes of Gout
Gout results from excessive uric acid production to break down purines, substances found naturally in the body and certain foods such as shellfish, red meat, and sugary drinks.

When uric acid exceeds its normal level, it forms crystals that deposit in joints, causing pain and swelling. High uric acid can also lead to tophi (lumps around joints) or kidney stones if crystals accumulate in the urinary tract.

Diagnostic Tests for Gout
Tests include:

Joint fluid analysis: Extracting fluid from the affected joint to identify urate crystals.

Blood tests: Measuring uric acid and creatinine levels, though these are not definitive alone.

X-ray imaging: To exclude other joint issues.

Ultrasound: Detects urate crystal deposits.

Dual Energy CT Scan: Identifies urate crystals even during acute inflammation.

Managing Gout Attacks

Rest and elevate the affected joint.

Apply ice packs to reduce swelling.

Use NSAIDs after consultation with your healthcare provider to alleviate pain and inflammation.

Preventing Future Attacks

Maintain a healthy weight; avoid fasting or crash diets that elevate uric acid.

Engage in regular exercise.

Limit alcohol intake, especially beer.

Reduce consumption of purine-rich foods like red meats and seafood.

Consult your doctor about medications that lower uric acid levels.

Medications for Gout Treatment

Short-term treatments: During attacks, NSAIDs, colchicine, or corticosteroids can provide quick relief from pain and inflammation.

NSAIDs

Colchicine

Corticosteroids

Long-term therapies: Aimed at lowering uric acid to prevent future attacks, including:

Uricosuric agents

Xanthine oxidase inhibitors

Colchicine

Pegloticase

Adherence to prescribed medication and lifestyle changes are crucial for effective gout management and prevention.