Gout Information

This article is an exceprt from arthritisnsw.org.au

The information provided below has been written for people affected by gout. It provides general information to help you understand gout and how to manage it. This sheet also covers ways to try to prevent gout and where to find more information.

What is gout?
Gout is a common and painful condition that affects the joints. Small crystals form in and around the joint, causing inflammation, pain and swelling. These crystals are made of one of the body’s normal waste products, uric acid. Normally the body rids itself of extra uric acid through the kidneys into the urine. However this does not happen fast enough in people with gout. This causes uric acid levels to build up and the crystals to form.

Who is affected by gout?
There are two main groups of people commonly affected by gout:
• men between the ages of 40 and 50 years
• older people taking diuretics (also known as ‘water pills’ or tablets which help the body get rid of water).

Gout in pre-menopausal women is rare and your doctor may wish to further investigate your symptoms.

What are the symptoms?
An attack of gout usually comes on very quickly, often overnight. The joint becomes very red, swollen and extremely painful. Often the joint is intensely sore to touch. Gout normally affects one joint at a time, often the joint of the big toe. Other joints, such as the hands, wrists, knees, ankles and elbows, can also be affected by gout.

What causes it?
Gout is usually caused by your kidneys not flushing uric acid out of your body quickly enough. Gout runs in families, although not all family members will be affected. There are some lifestyle factors which may increase your risk of developing gout, including:

• drinking alcohol
• dehydration (not drinking enough water)
• being overweight or overeating
• ‘crash’ dieting or fasting
• eating certain foods

Taking diuretics (water tablets) and/or having kidney disease also increases your risk of developing gout.

How is it diagnosed?
Gout is diagnosed by finding crystals of uric acid in fluid taken from your joint. Your doctor may test your urine to see if your body is getting rid of extra amounts of uric acid. Uric acid levels can also be measured by blood tests, however these are not always accurate. Uric acid levels may be normal or even lowered during an attack or gout. Blood tests are most useful in ruling out other types of joint infections or arthritis. X-rays are often normal in the early stages of gout so are not very useful in diagnosing gout.

What will happen to me?
Without treatment, a gout attack usually lasts about one week. Another attack may not happen for months or even years. If gout is not managed well, the time between attacks may get shorter, the attacks more severe and the joints can be permanently damaged. Sometimes gout can progress into a chronic (long term) condition, causing:
• constant mild pain & inflammation of the affected joints
• tophi – solid deposits (lumps) of uric acid crystals, especially on the ears, fingers, hands, forearms, knees, and elbow
• kidney stones.

What can I do during a gout attack?
You should see your doctor when you have your first attack of gout. Your doctor will recommend certain medicines to reduce pain and inflammation caused by gout, including:
• non-steroidal anti-inflammatory drugs (NSAIDs)
• corticosteroid injections or tablets
• colchicine.

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