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Texas Orthopedics

Gout

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Introduction

Gout is a disorder that can cause sudden joint pain.  It occurs most commonly in the big toe, although it may affect other joints.  The buildup of uric acid, a substance found naturally in the body and in certain foods, causes gout.  Episodes of gout tend to come and go.  Symptoms are treated with medications to ease pain and decrease inflammation.  Measures can be taken to help prevent gout in some cases.
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Anatomy

Uric acid is a natural substance that is found in the body.  The body uses uric acid to help break down purines, a substance found in the body and in certain foods, such as organ meats, mushrooms, and anchovies.  The kidneys eliminate uric acid in urine.  A build-up of uric acid can occur if the kidneys do not remove enough of it or if the body over produces it.  An excess of uric acid can lead to the formation of urate crystals.  The urate crystals in joints cause pain and inflammation.
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Causes

Gout is a type of arthritis that is caused by an excess of uric acid in the body.  The surplus of uric acid causes needle-shaped urate crystals to form in the joints or surrounding tissues. The urate crystals cause pain and inflammation.

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Symptoms

Gout usually begins with sudden symptoms, frequently during the night.  Gout most commonly develops in the big toe, but it can also occur in almost any joint.  Gout causes significant pain and tenderness.  The joint may appear red and swollen.
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Diagnosis

You should contact a doctor, such as a podiatrist, if you suspect that you have gout in your foot.  Diagnosis and treatment are necessary to prevent joint damage. A doctor can diagnose gout by examining your joint and conducting some tests. 
 
A joint fluid test is used to determine if urate crystals are in your joint fluid.  Your doctor will use a needle to draw fluid from your joint for testing.  Blood tests are used to test for the amount of uric acid in your blood.  Your doctor will interpret the results of these tests to confirm a diagnosis of gout.
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Treatment

Gout is treated with medications to relieve pain and inflammation, such as non-steroidal anti-inflammatory drugs, colchicine, and steroids.  Your doctor may prescribe medications to decrease uric acid production in your body or to help your body remove uric acid.  It may be helpful to limit foods that contain purines, such as red meat, and avoid drinking alcohol.  It may be helpful to drink plenty of water to help the kidneys eliminate uric acid.
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Prevention

You may help prevent gout by avoiding alcohol. 

Avoid eating foods that are high in purines and limit the amount of protein from meat that you eat to about 5 or 6 ounces per day.

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Am I at Risk

Gout most frequently develops in men between the ages of 40 and 50 years.  Women who develop gout tend to do so after menopause when their levels of uric acid rise.  Gout can be hereditary; meaning, if other people in your family have gout, your risk for the condition is increased.

Risk factors for gout include:
• Consuming alcohol
• High blood pressure
• High cholesterol and high triglycerides
• Diabetes
• Arteriosclerosis- Narrowing of the arteries
• Low-dose aspirin
• Certain diuretic medications (thiazide diuretics) and anti-rejection medications for organ transplant recipients
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Complications

In addition to causing gout, a build-up of uric acid can cause kidney stones.  Untreated gout can lead to advanced gout, which is associated with nodules of urate crystals that form under the skin (tophi).  For some people, gout is a recurring condition that happens several times a year.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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