Gout
Gout is a type of arthritis caused by too much uric acid in the blood, which forms sharp crystals inside a joint. It causes sudden attacks of a very painful, red, hot and swollen joint, most often the big toe. It is more common in men, in people who are overweight and in people with kidney disease or high blood pressure. Attacks can be treated quickly, and long-term medicine can prevent them.
Symptoms
- Sudden, severe pain in one joint, often starting at night
- The big toe is most often affected; also the ankle, knee, wrist or fingers
- The joint becomes red, hot, swollen and very tender, even to the touch of a bed sheet
- An attack usually settles within 1 to 2 weeks
- Over years, chalky lumps (tophi) under the skin and kidney stones
Causes
- High uric acid in the blood
- Large amounts of red meat, organ meats (liver, kidney) and some seafood
- Sugary drinks and alcohol
- Being overweight
- Dehydration, kidney disease and high blood pressure
- Some medicines, such as water tablets (diuretics) and low-dose aspirin
- Family history
Prevention
- Drink plenty of water every day
- Eat less red meat and organ meats, and fewer sugary drinks; avoid alcohol
- Lose weight slowly if overweight; avoid crash diets and long fasting without enough water
- If long-term uric-acid-lowering medicine is prescribed, take it every day, even when you feel well
- Tell your doctor you have gout before starting new medicines
Treatment
- During an attack: rest and raise the joint, apply a cool cloth, and take anti-inflammatory medicine or colchicine as prescribed by a doctor
- Start treatment early in the attack for the best effect
- For repeated attacks: long-term medicine such as allopurinol to lower uric acid, prescribed by a doctor
- If you already take allopurinol, do not stop it during an attack
- Blood tests to check uric acid and kidney function
- Do not use steroid injections or strong painkillers without a doctor
Common questions
Do I have to stop eating meat completely?
No. Diet alone rarely cures gout. Eating less red meat and organ meats, avoiding sugary drinks and drinking more water helps, but many people still need medicine to lower uric acid.
Why did my gout get worse when I started allopurinol?
When uric acid starts to fall, attacks can happen more often in the first few months. Your doctor may start with a low dose and give extra medicine to prevent attacks. Do not stop allopurinol on your own.