Gout
Gout is a common type of inflammatory arthritis caused by the buildup of uric acid crystals in the joints. It often begins suddenly with intense pain, swelling, redness and warmth, most frequently in the big toe. Other joints, such as the ankles, knees, wrists, fingers and elbows, can also be affected.
What Causes Gout?
Gout occurs when uric acid levels in the blood become too high, a condition called hyperuricemia. Uric acid forms when the body breaks down substances called purines, found in many foods and body tissues. Not everyone with high uric acid develops gout. Genetics, overall health, and how the body processes uric acid all contribute.
Symptoms of Gout
Gout attacks usually come on quickly and can worsen within a day. Symptoms include:
- Sudden and severe joint pain
- Swelling around the affected joint
- Redness and warmth
- Sensitivity to touch and limited joint movement
Without treatment, gout can lead to hard urate deposits under the skin (tophi), joint damage and kidney stones.
Who Is at Risk?
Risk factors for gout include:
- Male gender or postmenopausal female
- Older age
- Family history of gout
- Obesity
- Diets high in red meat, seafood, and other purine-rich foods
- Excessive alcohol, especially beer and spirits
- Certain medications, like some diuretics
- Conditions such as high blood pressure, diabetes, metabolic syndrome and chronic kidney disease
How Gout Is Diagnosed
Diagnosis begins with your medical history and a physical exam. Gout is confirmed by examining fluid from the affected joint for uric acid crystals. Blood tests to measure uric acid and imaging like ultrasound or X-rays may be used for complex cases or to check long-term joint changes.
Treatment Options
Treatment focuses on relieving pain during attacks and lowering uric acid to prevent future problems.
During an Attack:
- Medications such as NSAIDs, colchicine or corticosteroids may be prescribed.
Ongoing Management:
- Long-term uric acid–lowering medications may be used for frequent attacks, visible tophi, joint damage or kidney stones.
- Lifestyle changes such as maintaining a healthy weight, staying hydrated, limiting alcohol and reducing purine-rich foods are important.
If you notice symptoms or recurring joint pain, TidalHealth specialists can create a personalized care plan.
What causes a gout attack?
Uric acid crystals accumulate in a joint, triggering sudden inflammation and pain. Triggers can include changes in uric acid levels, dehydration, surgery, infections, certain foods or medications.
How is gout diagnosed?
The most definitive method is examining joint fluid for urate crystals. Blood tests and imaging may support diagnosis, especially when joint fluid cannot be tested.
Can uric acid be normal during a flare?
Yes. Blood levels may appear normal during an attack, so joint fluid analysis and symptoms are key for diagnosis.
What treatments relieve a gout attack?
NSAIDs, colchicine, and corticosteroids can reduce pain and inflammation. Early treatment helps control symptoms more quickly.
Do I need long-term medication?
Not always. Long-term treatment is recommended for frequent attacks, tophi, joint damage or uric acid kidney stones.
Can diet alone cure gout?
Diet helps reduce attack frequency and uric acid but usually cannot control gout on its own. A combination of diet, lifestyle changes and medication is most effective.
What foods and drinks trigger gout?
High-purine foods like red meat, organ meats and certain shellfish may trigger attacks. Beer, spirits and sugary drinks can also increase risk. Dairy, vegetables and coffee are less likely to cause issues.
Is gout hereditary?
Family history increases risk, but environment, diet and health conditions also contribute.
When should I go to the emergency department?
Seek care if you have severe pain that cannot be managed, signs of infection (fever, chills, red streaks), inability to move the affected limb or cannot take oral medications.
Can gout affect the kidneys?
Yes. Gout increases the risk of kidney stones and may affect kidney function over time.
What lifestyle changes help prevent attacks?
Maintain a healthy weight, limit alcohol, reduce purine-rich foods, stay hydrated and manage conditions like high blood pressure or diabetes. Regular healthcare practitioner check-ins improve prevention.
