What is Gout?
Gout is a type of inflammatory arthritis that causes sudden and severe attacks of pain, swelling, and redness in your joints. It can affect one or more joints in your body. Most commonly it affects the big toe joint, but it can also impact the ankles, knees, elbows, wrists, and fingers.
Gout symptoms tend to come and go in episodes, known as flares or gout attacks. Your doctor can help you manage and even prevent these flares.
A typical gout attack can last anywhere between 1 to 2 weeks, if not treated. Without proper care, future attacks may stick around even longer. And overtime, untreated gout can lead to permanent joint damage.
What are the Symptoms of Gout?
Gout symptoms usually appear suddenly and usually at night. A typical gout attack might look like this:
- Intense joint pain, often starting in the big toe.
- Swelling and redness around the affected joint.
- Warmth, often as a feeling like the joint is “on fire”.
- Tenderness, even a slight touch of bedsheet on the affected joint can be unbearable.
- Limited range of motion in the joint.
What Causes Gout?
Gout is caused by an increased level of uric acid in the body (hyperuricemia). Uric acid is a waste product formed by our body when it breaks down the substances known as purines, that are naturally found in our bodies and certain foods.
Normally uric acid goes in the blood and passes through the kidneys into the urine. But when there is too much of it, or our kidneys can’t get rid enough— uric acid builds up and crystals may form and settle in your joints. These sharp crystals in your joints trigger sudden attacks of pain, swelling, and other uncomfortable symptoms.
However, just having high uric acid levels for a while, doesn’t necessarily mean you’ll have gout. In fact, many people with hyperuricemia never develop gout.
Common causes include:
- Overproduction of uric acid in the body.
- Under excretion of uric acid by the kidneys.
- Having a diet high in purines (such as red meat, certain seafoods, and alcohol).
- Certain medical conditions like kidney diseases, diabetes, and congestive heart failure.
- Medications such as some diuretics (water pills).
Risk Factors for Gout:
Gout can affect anyone, but there are some factors that increase your chances of developing it. These include:
- Gender— men are more likely to develop gout, women become more at risk after menopause.
- Diet— consuming a lot of red meat, shellfish, and alcohol.
- Weight— obesity increases your risk of developing gout.
- Medical conditions— like high blood pressure and diabetes.
- Medications— such as thiazide diuretics.
- Family history of gout.
Management and Treatment:
If you’ve had a gout attack, you know it’s not something you want to experience again. Fortunately, there are ways to manage it. Managing gout usually involves two key steps: controlling symptoms during a flare-up and making long-term changes in your diet— especially by cutting back foods and drinks high in purines.
1. Medications for Gout:
Your doctor might prescribe you one or more medications to help ease symptoms during a flare-up and to prevent future ones. Common options include:
- NSAIDs (Nonsteroidal Anti-inflammatory Drugs): Over-the-counter options like ibuprofen or naproxen can help reduce pain and swelling during a gout flare. However, these aren’t suitable for everyone— especially for people with kidney issues, stomach ulcers, or other health conditions. Always check with your doctor before taking them.
- Colchicine: This prescription drug works best when taken within the first 24 hours of a gout attack. It helps reduce inflammation and reduce pain.
- Corticosteroids: These help reduce inflammation and can be taken by mouth or injected in the affected joint. Your doctor might recommend them if NSAIDs and colchicine aren’t a good fit for you.
To help prevent future attacks, your doctor may also prescribe medications that reduce uric acid levels in your blood, such as:
- Allopurinol
- Febuxostat
- Probenecid
2. Dietary Changes:
In addition to medications, your healthcare provider may recommend following a low-purine diet. This involves cutting back on purine rich foods (like red meat, certain seafoods, and alcohol) that can raise uric acid levels.
The goal is to reduce the overall amount of uric acid in your body, to help prevent future flare-ups. You’ll also be encouraged to eat more foods that help reduce uric acid levels, such as:
- Skimmed milk
- Cherries
- Coffee
- Foods rich in Vitamin C
- Fruits and vegetables
- Whole grains (except oats)
Learn more about managing joint pain.
Prevention Tips:
Preventing gout is all about reducing uric acid levels and avoiding the things that can trigger a flare.
Here are a few practical tips for you to follow:
- Watch your diet. Cut back on foods high in purines such as red meat, organ meat, sugary drinks, and alcohol.
- Stay hydrated. Water helps flush uric acid from your system.
- Maintain a healthy body weight. Obesity is a risk factor for developing gout.
- Exercise regularly. Physical activity supports overall health and reduces the risk of many chronic conditions.
- Limit sugary foods (particularly fructose) as they can also increase uric acid levels.
When to See a Doctor?
If you suspect you’re experiencing gout for the first time, or having a flare up, it’s a good idea to consult your doctor. You should also seek medical attention if:
- You have a sudden intense joint pain.
- Your joint is red, swollen, and warm.
- You’ve had multiple attacks in a short period.
- You’re having fever along with joint pain (which can indicate infection).
Ignoring gout can lead to joint damage over time or the development of tophi— hard lumps of uric acid crystals that form under the skin.
Final Thoughts:
Gout may feel that it comes out of nowhere but there are clear triggers and manageable steps you can take. By understanding what causes it, recognising the symptoms early, and making lifestyle changes, most people can control their gout and live comfortably.
If you’re unsure whether your symptoms point towards gout, talk to your healthcare provider and get the help you need.
