Overview, Causes, & Risk Factors
Gout is a form of arthritis,or joint inflammation, that is caused by increased uric acid in thebloodstream. Uric acid is a chemical produced by the normal breakdown of cells.
What is going on in the body?
Gout results from an excess of uric acid in the body. The excess uric acid isdeposited in 1 or more joints, causing arthritis.
What are the causes and risks of the disease?
Gout is caused by an excess of uric acid in the bloodstream. Uricacid accumulates in the body and may form crystals in the joints under the following conditions:
Certain risk factors increase a person’s chance of developing gout or having aflare-up of symptoms once he or she has the disease. These factors include the following:
Gout occurs in approximately 1 in 5,000 people. It is more common in men, althoughwomen are at increased risk after menopause, the end of normal menstruation.
Symptoms & Signs
What are the signs and symptoms of the disease?
Gout can cause a sudden onset of severe joint pain such as the following:
Although gout is most commonly seen in the great toes, it may also affect thejoints of the fingers, hands, feet, or toes. Less commonly, the hips,shoulders, elbows, and wrists can be involved.
Following are other symptoms of gout:
Diagnosis & Tests
How is the disease diagnosed?
The diagnosis of gout starts with a medical history and physical examination. Then thehealthcare provider may do a jointaspiration, inserting a needle into the joint space to remove someof the joint fluid. The fluid is examined in the laboratory for the presence ofuric acid crystals.
There also are blood tests that can be used to check for uric acid, but the results may benormal or even low in people with gout. Joint X-rays may be used to rule out any other abnormalities.Usually, if gout is in the acute stage, the joint X-rays will be normal.
Prevention & Expectations
What can be done to prevent the disease?
Some cases of gout can be prevented by controlling conditions that are strongly associated with gout,such as high blood pressureor high cholesterol.
What are the long-term effects of the disease?
People with gout can live normal lives. But when the disease is active, it canhave a significant effect on quality of life. Gout can progress to a chronicstate, and it can lead to kidneystones and chronic changes in the affected joints. The chronicstage is more likely to occur when the disease starts before the age of 30.Untreated gout can lead to permanent disability.
What are the risks to others?
Gout is not contagious and poses no risk to others.
Treatment & Monitoring
What are the treatments for the disease?
There are treatments for both the acute phase of gout and for preventingflare-ups of symptoms. For acute attacks, the anti-inflammatory medicationcolchicine is used to reduce the pain. Indomethacin and other nonsteroidalanti-inflammatory drugs, or NSAIDs, like ibuprofen, are also useful.Occasionally, painmedications may be prescribed.
After the acute attack has resolved, other medications can be used to minimizeacute attacks of gout. Allopurinol blocks the body’s production of uric acidand probenicid helps the kidneys eliminate excess uric acid.
A person with gout will also be advised to make the followinglifestyle changes:
What are the side effects of the treatments?
Colchicine, nonsteroidal anti-inflammatory drugs, also called NSAIDs, andallopurinol may cause nausea, vomiting, diarrhea, abdominaldistress, and allergicreactions.
What happens after treatment for the disease?
People who have gout can have recurrent episodes throughout their lives. Theseepisodes are not always associated with increases in the uric acid level in theblood. Early treatment of acute gout attacksis important. This helps improve the quality of life and reduces the chances ofany chronic changes in the joint.
How is the disease monitored?
The healthcare provider will describe how to monitor the disease. Most willwant to know about the number of attacks, the length of each attack, and whichjoint is involved. The provider will also monitor uric acid levels and any sideeffects of the medications. Any new or worsening symptoms should be reported tothe healthcare provider.
Article type: xmedgeneral