Gout is a common form of inflammatory arthritis that causes very painful symptoms, such as pain and swelling that come and go in periods called gout attacks or flare-ups.
What Are The Symptoms Of Gout?
The first signs of having a gout attack include intense pain, redness, stiffness, swelling, tenderness and feeling that the joint is ‘on fire’.
Gout most commonly affects your big toe joint but it can also affects other joints including the knees, ankles, feet, hands and wrists and elbows. Men are three times more likely to develop gout than women.
Gout attacks usually last for one to two weeks. Some flares last longer than others, and some might cause more severe symptoms. Between attacks (during remission), you might not experience any symptoms.
What Causes Gout?
Your kidneys are responsible for filtering uric acid out of your blood. Uric acid exits the body when you urinate. However, sometimes our bodies produce too much uric acid or our kidneys can’t filter it fast enough. This can lead to having high levels of uric acid in our blood (known as hyperuricemia), which causes uric acid crystals to accumulate and settle in our joints.
You are more likely to get gout if you have a biological parent or grandparent who has it. A diet rich in animal proteins, especially when combined with drinking alcohol regularly, can cause uric acid to build up in your body, which can put you at risk of a gout attack.
How Is Gout Diagnosed?
Your doctor will diagnose gout with a series of stes:
- A physical exam including your affected joints
- Questions about your symptoms
- Blood tests to measure the uric acid levels in your blood
- Imaging tests (such as X-rays, CT or MRI) to examine your affected joint or to see if gout has caused any changes in your joints
- A fluid sample from inside a joint (occasionally)
Treating Gout With Medication
Besides recommending dietary and lifestyle changes, your doctor might suggest medications to help manage your symptoms during an attack. It is important to get treatment immediately if you feel an attack starting. Treatment may include:
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can reduce pain and swelling during a gout attack. You may need a script for naproxen.
- Colchicine is a prescription medication that reduces inflammation and pain if taken within 24 hours of a gout attack.
- Corticosteroids are prescription medications that reduce inflammation. They may be prescribed as a pill or injected directly into the affected joint.
Treating Gout With Lifestyle Changes
Treating gout usually requires a combination of treating your symptoms with medication during a flare and reducing high-purine foods and drinks in your diet.
Making lifestyle changes can help to stop or reduce gout flare-ups. These changes can include maintaining a healthy weight, eating a balanced diet, staying hydrated, exercising regularly, limiting your alcohol intake, and not smoking.
Consuming foods high in purines are more likely to lead to high uric acid levels, which in turn lead to gout. Eliminating or reducing the following items may be helpful in preventing gout attacks:
- Sugary drinks and sweets.
- High fructose corn syrup which is often found food products and processed snacks
- Alcohol, which prevents your kidneys from eliminating uric acid
- Organ meats including liver, tripe, sweetbreads, brains, and kidneys
- Game meats including goose, veal, and venison
- Seafoods including herring, scallops, mussels, codfish, tuna, trout and haddock
- Red meat such as beef, lamb, pork, and bacon
- Gravy and meat sauces
Frequently Asked Questions
Your big toe is the most common site for a gout attack - a condition known as "podagra”. The joint at the base of your big toe is more prone to the deposition of uric acid, due to it’s anatomy.
It is also located at an extremity, far from the heart, meaning that it is one of the coldest joints in your body. Uric acid cristalises at lower temperatures. All of this combines to mean that there is more uric acid in your big toe joint, that crystalises at colder temperatures.
Your big toe also takes a lot of pressure and minor trauma during your every-day life, which could dislocate some of the uric acid crystals and lead to a gout attack.