Gout

Gout

Gout is a form of arthritis that's both common and complex—often described as sudden, severe attacks of pain, swelling, redness, and tenderness in one or more joints. Patients often experience this discomfort in their big toe.

An attack of gout can be sudden with the sensation that your big toe is on fire. The affected joint can be hot, swollen and tender to the touch. The affected area is so sensitive that the slightest touch may feel intolerable for the patient.

Symptoms of gout may come and go, but there are ways to manage it and prevent flareups from occurring.

Signs and Symptoms of Gout

Symptoms of gout can occur suddenly and often at night.

They include:

• Intense joint pain: gout typically affects the big toe, but it's also known to affect other joints, such as the ankles, knees, elbows, wrists and fingers. The most pain and discomfort will most likely last at the beginning of the flareup, which could be the first four to 12 hours.
• Lingering discomfort: after the intense pain subsides, joint discomfort can last from a few days to a few weeks
• Inflammation and redness: joints appear swollen, tender, warm and red
• Limited range of motion: as gout progresses, your range of motion in the joint will likely be limited

Call your doctor when you experience intense pain in your joint. Gout left untreated can lead to worsening pain and damage to your joints. Seek medical care immediately if you have a fever and the joint is hot and inflamed. This can be a sign of infection.

Causes of Gout

Gout occurs when urate crystals accumulate in your joint. This can lead to inflammation and intense pain during a gout attack. Urate crystals can form when you have high uric acid levels in your blood. Your body produces these uric acids when it breaks down purines which are substances found naturally in your body.

Purines can be found in the food we eat, such as red meat and organ meats like liver. Purine-rich sea foods can include anchovies, sardines, mussels, scallops, trout and tuna. They can also be found in alcoholic beverages, especially beer. Drinks sweetened with fruit sugar (fructose) can also promote higher uric acid levels.

Typically, uric acid dissolves in your blood and passes through your kidneys into your urine. However, sometimes either your body produces too much uric acid, or your kidneys excrete too little uric acid. As a result, uric acid can build up, forming sharp, needlelike urate crystals in the joints or surrounding tissue. This can lead to extreme pain, inflammation and swelling.

Gout Diagnosis

Doctors will generally diagnose gout based on your symptoms and the appearance of the affected joint.

Your doctor may also request the following tests to determine how severe the condition is:

• Joint fluid test: your doctor may use a needle to draw fluid from your affected joint. Urate crystals may be seen when the fluid is examined under a microscope
• Blood test: your doctor may ask for a blood test to measure the levels of uric acid in your blood. However, some people have high levels of uric acid but don't experience gout or have symptoms of gout but don't have high levels of uric acid
• X-ray imaging: joint X-rays can help doctors determine if there are any additional causes for your joint inflammation other than gout
• Ultrasound: using sound waves, your doctor can detect the urate crystals in your joints
• Dual-energy computerized tomography (DECT): combining X-ray images from multiple angles can help visualize the urate crystals in the joints better

Treatment for Gout

Goud treatments are used to treat two areas of the condition. Medications can be used to treat gout attacks, and other medications can be used to prevent gout complications. The first one is used to reduce inflammation and pain associated with gout attacks. The second type is used in order to avoid gout complications by lowering the amount of uric acid in your blood.

Depending on your condition and the symptoms you may be experiencing, your doctor may recommend these medications.

Medications to Treat Gout Attacks

To prevent future gout attacks, your doctor may recommend one of the following:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs can include over-the-counter options such as ibuprofen (Advil, Motrin IB, etc.)
• Colchicine
• Corticosteroids

Medications to Prevent Gout Complications

If you experience several gout attacks each year or they are less frequent but painful, your doctor may prescribe you a medication to reduce your risk of gout-related complications. A medication to lower your body's level of uric acid may be recommended if you experience chronic kidney disease or kidney stones. If there's significant joint damage shown in your X-rays, your doctor may also recommend medication.

• Medications to block uric acid production: drugs such as allopurinol (Aloprim, Lupurin, Zyloprim) and febuxostat (Uloric) can help limit the amount of uric acid your body makes. Side effects of allopurinol include fever, rash, hepatitis, and kidney problems. Febuxostat side effects may include rash, nausea, and reduced liver function. Febuxostat may also increase the risk of heart-related death.
• Medications to improve uric acid removal: drugs such as probenecid (Probalan) may help improve your kidneys' ability to remove uric acid from your body. Side effects may include a rash, stomach pain, and kidney stones.

INTEGRIS Health's rheumatology services provide comprehensive and specialized care for gout patients, emphasizing the importance of personalized treatment plans tailored to individual needs.

With a team of experienced rheumatologists, advanced diagnostic tools, and a patient-centered approach, we aim to alleviate pain, reduce inflammation, and improve the overall quality of life for individuals suffering from gout. By combining innovative treatments, education, and ongoing support, INTEGRIS Health strives to empower patients to effectively manage their condition and achieve long-term relief from gout symptoms.