Gout: Symptoms, causes, and treatment (2022)

Gout is a common type of arthritis that causes intense pain, swelling, and stiffness in the joints. It usually affects the joint at the base of the big toe, known as the metatarsophalangeal joint. Its main cause is the presence of too much uric acid in the body.

Gout affects more than 3 million Americans and is the most common form of inflammatory arthritis in males. And although it is less likely to affect them overall, females have a higher rate of developing gout after menopause.

Gout attacks can come on quickly and may keep recurring over time. This ongoing resurgence can slowly harm tissue in the inflammation area and can be extremely painful. Hypertension, cardiovascular conditions, and obesity are risk factors for gout.

Hyperuricemia, where there is too much uric acid in the body, is the main cause of gout.

People will typically treat the condition with prescription medication. These drugs can help treat the symptoms of gout attacks, prevent future flares, and reduce the risk of complications such as kidney stones and tophi. Tophi refers to when acid crystals form masses of white growths that develop around the affected areas.

Common medications include nonsteroidal anti-inflammatory drugs and corticosteroids, another anti-inflammatory. These reduce swelling and pain in the areas affected by gout.

Excessive uric acid levels are typically due to the overproduction of uric acid or issues with the kidneys in excreting this substance adequately. A person may use medicines to reduce uric acid production or improve the kidney’s ability to remove uric acid from the body.

Without treatment, an acute gout attack will be at its worst between 12 and 24 hours after it began. A person can expect to recover within 1–2 weeks without treatment, but there may be significant pain during this period.

Tests and diagnosis

Gout can often be challenging to diagnose, as its symptoms are similar to those of other conditions. While hyperuricemia occurs in most people who develop gout, it may not be present during a flare-up. As a result, a person does not need to have hyperuricemia for a diagnosis.

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High levels of uric acid in an individual’s blood or urate crystals in their joint fluid are the main diagnostic criteria for gout.

To assess this, a rheumatologist will carry out a blood test and may also extract fluid from an affected joint for analysis.

In addition, they can search for urate crystals around joints or within growths using an ultrasound scan. X-rays cannot detect gout, but healthcare professionals may use them to rule out other causes.

As joint infections can also cause similar symptoms to gout, doctors can look for bacteria when carrying out a joint fluid test to rule out a bacterial cause.

There are various stages through which gout progresses.

Asymptomatic hyperuricemia

A person can have elevated uric acid levels without any outward symptoms. While individuals do not need treatment at this stage, high uric acid levels in the blood can cause silent tissue damage.

As a result, a doctor may advise a person with high uric acid levels to address factors possibly contributing to its buildup.

Acute gout

This stage occurs when urate crystals in a joint suddenly cause acute inflammation and intense pain. This sudden attack is a “flare” and may last between 3 days and 2 weeks. Stressful life events and excessive alcohol consumption could be contributors to flare-ups.

Interval or intercritical gout

This stage is the period in between attacks of acute gout. As a person’s gout progresses, these intervals become shorter. Between these periods, urate crystals may continue to build up in tissue.

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Chronic tophaceous gout

Chronic tophaceous gout is the most debilitating type of gout and may result in permanent damage to the joints and the kidneys. At this stage, people can have chronic arthritis and develop tophi in cooler areas of the body, such as the joints of the fingers.

Chronic tophaceous gout typically occurs after many years of acute gout attacks. However, it is unlikely that individuals who receive proper treatment progress to this stage.

Pseudogout

One condition that experts easily confuse with gout is calcium pyrophosphate deposition, known as pseudogout. The symptoms of pseudogout are very similar to those of gout, although the flare-ups are usually less severe.

The major difference between gout and pseudogout is that the joints are irritated by calcium pyrophosphate crystals rather than urate crystals. Pseudogout requires different treatments than gout.

Hyperuricemia, an excess of uric acid in the blood, is the leading cause of gout.

The body produces uric acid during the breakdown of purines. These are chemical compounds found in high amounts in certain foods such as meat, poultry, and seafood.

Typically, uric acid is dissolved in the blood and excreted from the body in urine via the kidneys. If a person produces too much uric acid or does not excrete enough, it can build up and form needle-like crystals. These trigger inflammation and pain in the joints and surrounding tissue.

Risk factors

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Several factors can increase the likelihood of hyperuricemia and gout, including the below.

  • Age: Gout is more common in older adults and rarely affects children.
  • Sex: In people under the age of 65 years, gout is four times as prevalent among males than females. This ratio slightly decreases in people over the age of 65 years to be three times as likely.
  • Genetics: A family history of gout can increase the likelihood of a person developing the condition.
  • Lifestyle choices: Alcohol consumption interferes with the removal of uric acid from the body. Eating a high-purine diet also increases the amount of uric acid in the body. Both of these can lead to gout.
  • Lead exposure: Studies have suggested a link between chronic lead exposure and an increased risk of gout.
  • Medications: Certain medications can increase the levels of uric acid in the body. These include some diuretics and drugs containing salicylate.
  • Weight: Being overweight or obese and having high levels of visceral body fat have associations with an increased risk of gout. However, being overweight or obese cannot directly cause the condition.
  • Other health conditions: Renal insufficiency and other kidney conditions can reduce the body’s ability to remove waste, leading to elevated uric acid levels. Other conditions associated with gout include high blood pressure and diabetes.

The main symptom of gout is intense joint pain that subsides to discomfort, inflammation, and redness.

The condition frequently affects the base of the big toe but can also occur in the forefoot, ankles, knees, elbows, wrists, and fingers.

Complications

In some cases, gout can develop into more severe conditions, including kidney stones or recurrent gout.

There are many lifestyle and dietary guidelines a person can try to protect against flares or prevent gout from occurring in the first instance:

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  • maintaining a high fluid intake of around 2–4 liters a day
  • avoiding alcohol
  • maintaining a moderate weight

Individuals with gout can manage flare-ups by moderating what they eat and drink — a balanced diet can help reduce symptoms.

Decreasing foods and drinks high in purines to ensure that uric acid levels in the blood do not get too high is an important first step.

Foods high in purines include:

  • red meats
  • game meats
  • glandular meats, such as kidneys, livers, and sweetbreads
  • seafood
  • shellfish
  • alcohol
  • foods and drinks sweetened with high fructose corn syrup

A person can reduce their risk of developing gout by limiting their intake of purine-rich foods. However, avoiding purine consumption altogether is not necessary. Moderate consumption of purine-rich items can help manage uric acid levels and gout symptoms and benefit overall dietary health.

Gout is a type of inflammatory arthritis. As a result, a person experiencing symptoms of gout may benefit from general arthritis home treatments. These include staying active, maintaining a moderate weight, and performing low-impact exercises to supportjoint health.

Gout is a common form of arthritis that affects the joints. It can lead to intense pain, swelling, and stiffness. The condition affects more than 3 million Americans and is more prevalent in males than females.

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Hyperuricemia — when too much uric acid is present in a person’s blood — is the leading cause of gout.
Individuals may experience hyperuricemia if their body overproduces uric acid or if their kidneys do not excrete the substance adequately.

A doctor will typically recommend prescription medications to treat gout. This may include treatments to reduce inflammation in the affected joints and drugs to help regulate uric acid levels.

People can help reduce their risk of developing gout by avoiding foods high in purines that the body converts into uric acid, keeping adequately hydrated, and avoiding alcohol.

FAQs

What is the main cause of gout? ›

Gout is caused by a condition known as hyperuricemia, where there is too much uric acid in the body. The body makes uric acid when it breaks down purines, which are found in your body and the foods you eat.

What foods causes gout? ›

The top 10 foods and drinks that trigger gout are:
  • Sugary drinks and sweets. ...
  • High fructose corn syrup. ...
  • Alcohol. ...
  • Organ meats. ...
  • Game meats. ...
  • Certain seafood, including herring, scallops, mussels, codfish, tuna, trout and haddock.
  • Red meats, including beef, lamb pork and bacon.
  • Turkey.
14 Mar 2022

What is the fastest way to get rid of gout? ›

Treatment
  1. Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include over-the-counter options such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve), as well as more-powerful prescription NSAIDs such as indomethacin (Indocin, Tivorbex) or celecoxib (Celebrex). ...
  2. Colchicine. ...
  3. Corticosteroids.

What foods help gout go away? ›

Eat more fruits, vegetables and whole grains, which provide complex carbohydrates. Avoid foods and beverages with high-fructose corn syrup, and limit consumption of naturally sweet fruit juices. Water. Stay well-hydrated by drinking water.

What fruit is good for gout? ›

Eat: Citrus Fruits

Grapefruit, oranges, pineapples, and strawberries are all great sources of vitamin C, which lowers your uric acid levels and helps prevent gout attacks.

Are bananas good for gout? ›

Bananas are low in purines and high in vitamin C, which makes them a good food to eat if you have gout. Changing your diet to include more low-purine foods, like bananas, can lower the amount of uric acid in your blood and reduce your risk of recurrent gout attacks.

Is lemon good for uric acid? ›

Lemon juice may help balance uric acid levels because it helps make the body more alkaline. This means it slightly raises the pH level of blood and other fluids. Lemon juice also makes your urine more alkaline.

Can gout go away on its own? ›

An acute gout attack will generally reach its peak 12-24 hours after onset, and then will slowly begin to resolve even without treatment. Full recovery from a gout attack (without treatment) takes approximately 7-14 days.

What are the 4 stages of gout? ›

Gout progresses through four clinical phases: asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout (intervals between acute attacks) and chronic tophaceous gout. Demonstration of intra-articular monosodium urate crystals is necessary to establish a definitive diagnosis of gouty arthritis.

How long does gout take to heal? ›

An episode of gout usually lasts for about 3 days with treatment and up to 14 days without treatment. If left untreated, you're more likely to have new episodes more frequently, and it can lead to worsening pain and even joint damage. During an episode of gout, you'll experience intense joint pain.

Does drinking water help gout flare up? ›

You can also help reduce the number of gout attacks you have by drinking plenty of fluids, especially water, but you should avoid drinks sweetened by sugar or too much fruit juice as these can trigger an attack. Diet drinks are fine.

Does walking help gout? ›

It is safe for people to walk with gout. In fact, doing joint friendly activities such as walking can help improve gout-related pain. Gout is a form of arthritis that usually affects the big toe joint, but it can also affect the lesser toes, ankles, and knees. It normally affects one joint at a time.

What is the best thing to drink if you have gout? ›

There are also many things you can add to your diet to help avoid or manage gout. Drink plenty of water, milk and tart cherry juice. Drinking coffee seems to help as well. Be sure to talk with your doctor before making any dietary changes.

Is Egg good for gout? ›

Eggs are a good protein source for people with gout, because eggs are naturally low in purines.

What vegetables to avoid if you have gout? ›

Eat plenty of vegetables such as kailan, cabbage, squash, red bell pepper, beetroot, but limit the intake of vegetables with moderate purine content such as asparagus, spinach, cauliflower and mushrooms. Eat fruits high in vitamin C such as oranges, tangerines, papaya and cherries.

What fruits are not good for gout? ›

Fruit, Fructose, and Gout

Researchers report a correlation between foods high in fructose and gout symptoms, which can include chronic pain. These fruits include apples, peaches, pears, plums, grapes, prunes, and dates.

How do you flush uric acid? ›

Drink at least 10-12 eight-ounce glasses of non-alcoholic fluids daily, especially if you have had kidney stones. This will help flush the uric acid crystals out of your body.

What causes gout in foot? ›

Gout is caused by a build-up of a substance called uric acid in the blood. If you produce too much uric acid or your kidneys don't filter enough out, it can build up and cause tiny sharp crystals to form in and around joints. These crystals can cause the joint to become inflamed (red and swollen) and painful.

Does tumeric help gout? ›

If you have gout, try turmeric as a home remedy. Its most active chemical, curcumin, has potent anti-inflammatory and antioxidant properties. This may help ease gout-related inflammation and pain. When eaten in foods, turmeric is generally safe.

Which food reduce uric acid fast? ›

In fact, here are six foods that can reduce uric acid naturally:
  • Bananas. If you have developed gout because of high uric acid, then having a banana everyday can reduce lower uric acid in your blood, thereby reducing your risk of gout attacks. ...
  • Apples. ...
  • Cherries. ...
  • Coffee. ...
  • Citrus fruits. ...
  • Green tea.
28 Sept 2020

Is Ginger good for uric acid? ›

Ginger. Ginger is known to help with digestion and ease nausea, but it can also help with inflammation, including gout. One animal study, for example, found ginger lowered uric acid levels in subjects who consumed ginger internally.

What happens if gout not treated? ›

If left untreated, gout can cause erosion and destruction of a joint. Advanced gout. Untreated gout may cause deposits of urate crystals to form under the skin in nodules called tophi (TOE-fie).

Can gout be caused by stress? ›

Gout attacks may be triggered by any of the following: Drinking alcohol. Eating a lot of protein-rich foods. Emotional stress.

Does gout go away on its own? ›

An acute gout attack will generally reach its peak 12-24 hours after onset, and then will slowly begin to resolve even without treatment. Full recovery from a gout attack (without treatment) takes approximately 7-14 days.

Can drinking lots of water stop gout? ›

You can also help reduce the number of gout attacks you have by drinking plenty of fluids, especially water, but you should avoid drinks sweetened by sugar or too much fruit juice as these can trigger an attack. Diet drinks are fine.

Does lemon water help gout? ›

The studies concluded that lemons and lemon juice might be a useful remedy to help treat gout, along with medications and other dietary changes. Lemon juice may also help prevent gout in people with high uric acid levels.

What not to eat if you have gout? ›

Foods to Avoid if You Have Gout

Beer and grain liquors (like vodka and whiskey) Red meat, lamb, and pork. Organ meats, such as liver, kidneys, and glandular meats like the thymus or pancreas (you may hear them called sweetbreads) Seafood, especially shellfish like shrimp, lobster, mussels, anchovies, and sardines.

How many days gout will go away? ›

An attack of gout usually lasts 5 to 7 days, then gets better. It may not cause lasting damage to joints if you get treatment immediately. Ask for an urgent GP appointment or call 111 if: the pain is getting worse.

Does walking on gout foot make it worse? ›

It is safe for people to walk with gout. In fact, doing joint friendly activities such as walking can help improve gout-related pain. Gout is a form of arthritis that usually affects the big toe joint, but it can also affect the lesser toes, ankles, and knees.

What will happen if gout is left untreated? ›

If the cause of gout isn't treated, acute attacks happen more and more often. The inflammation caused by these attacks, as well as the growth of tophi, causes damage to joint tissues. Arthritis caused by gout may lead to bone erosion and cartilage loss leading to complete destruction of the joint.

Does soaking in hot water help gout? ›

Soaking in cold water is most often recommended and considered most effective. Ice packs may also work. Soaking in hot water is typically only recommended when inflammation isn't as intense. Alternating hot and cold applications may also be helpful.

Can you get rid of gout without medicine? ›

Most gout attacks will go away by themselves in several weeks, even without treatment.

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