The arthritic condition gout can cause joint pain so severe that lightly touching the affected area is very uncomfortable.
More than 8 million Americans suffer with the disease, according to WebMD. A gout attack can hit suddenly, catching patients off guard with excruciating pain, most commonly in the big toe.
Dr. Robert Ishak, a doctor of internal medicine at University of Maryland Upper Chesapeake Health Primary Care, said there is no cure for the disorder, but that there are ways for people to manage it.
What is gout?
Gout is an extremely painful condition that sometimes can last for several days. It is a form of arthritis characterized by sudden intermittent attacks of swollen, warm and very tender joints. Usually it affects one joint at a time, typically the big toe is the most common joint involved.
It is an inflammatory arthritis in which an individual’s immune system responds to a build-up of uric acid crystals inside the joint, which is what causes the intense pain and swelling during these attacks. Gout is different from the more typical type of arthritis or osteoarthritis in which joints or joint cartilage wear down from overuse and age (wear and tear).
Gout attacks can also involve the feet, ankles and hands, as well as the soft tissues surrounding the joints. In some patients with recurrent gout attacks and chronically high levels of uric acid in the bloodstream, uric acid crystals can accumulate and surround the joints. These are known as tophi.
What are the symptoms of gout?
Symptoms of gout include sudden and severe episodes of pain in a joint, stiffness and swelling, redness and tenderness.
What puts people at risk for gout?
People all have some levels of uric acid in their bloodstream, however some patients are more prone to gout attacks than others. Uric acid is mostly derived as a by-product of a body's metabolism. Some patients have a genetic predisposition to gout, causing elevated levels of uric acid. Uric acid can also be a result of people’s diets and come from dietary sources (shellfish, red meat, alcohol), medications and certain disease states, such as chronic kidney disease and blood disorders. Gout is also more common in obese and elderly patients.
How is gout treated?
Gout is treated on two levels. Acute attacks are treated with anti-inflammatory drugs such as NSAIDS (ibuprofen), steroids (prednisone), or colchicine on an intermittent basis. All of these drugs have their own side effects and drug interactions so it is important to consult with your healthcare provider to help decide which is the best medication for you. Recurrent flares of gout can be treated with preventative medications, which you have to take on a daily basis in most situations. These drugs help reduce uric acid levels by reducing production, increasing elimination or by helping break down uric acid in our body.
If left untreated, what other health problems can gout lead to?
Chronic gout or untreated gout can lead to tophi or tophaceous gout, which in turn can lead to joint deformities and erosion of bone around involved joints. Sudden elevations of uric acid often seen in cancer patients can cause acute kidney damage. Chronic uric acid elevations are often associated with chronic kidney disease. Uric acid crystals can also form kidney stones.
What can people do to decrease their risk factors?
Gout can be somewhat prevented with dietary changes and weight reduction. Patients should consult with their healthcare provider to help treat acute and recurrent attacks of gout.