Gout is a complex form of arthritis that causes swelling, redness and pain in a joint. Attacks are often sudden and severe, leaving the affected joint tender and hot to the touch. In most cases, the joint at the base of the big toe is affected; however, this disease can also attack ankles, knees, wrists and other joints. Over time, attacks can increase in duration, frequency and severity. Left untreated, this form of arthritis may damage tendons and other tissues. Gout is most commonly seen in men, but women have an increased risk for developing the disease after menopause.
Causes of Gout
Gout occurs when too much uric acid accumulates in the blood, a condition known as hyperuricemia. Normally, the uric acid produced by the body and found in certain foods dissolves in the blood and is eliminated through the kidneys. If the body produces too much uric acid, or if the kidneys do not excrete enough, it builds up in the joints, forming urate crystals. These sharp, needle-like crystals are responsible for the pain and inflammation characteristic of gout. The exact cause of gout is not always known, but certain risk factors can increase the likelihood of developing the disease. Family history, obesity, untreated high blood pressure and a diet high in meat, seafood or alcohol can all put a person at greater risk.
Gout can be difficult to diagnose because the symptoms can mimic those of other medical conditions. The only way to identify gout properly is through a joint fluid analysis. This procedure involves using a needle to draw fluid from the affected joint, which is then analyzed microscopically for evidence of urate crystals. If joint fluid cannot be safely extracted, a blood or urine test can measure the body’s level of uric acid. These tests can be misleading, however, as a high level of uric acid does not always relate to the presence of gout. In diagnosing this disease, the doctor may order X-rays of the affected joint in order to rule out other types of arthritis and other causes of inflammation.
Treatments for Gout
Rest and ice can help in the event of an acute gout attack, but most attacks are typically treated with short-term medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids or colchicine, a drug proven to be particularly effective at reducing gout pain. If attacks are frequent or extremely painful, gout is considered to be chronic and may require long-term medication to reduce the risk of complications.