Gout is a form of arthritis and is most common in men older than 30. It is less common in women. In women it usually comes after menopause. It is caused by increased blood levels of uric acid, which is made by the breakdown of protein in the body. When blood levels of uric acid rise above a critical level, thousands of hard, tiny uric acid crystals collect in the joints. These crystals act like tiny, hot, jagged shards of glass, resulting in pain and inflammation. Crystals can collect in the tendons and cartilage, in the kidneys (as kidney stones), and in the fatty tissues beneath the skin. {Note: Crystals other than uric acid can cause some acute attacks similar to gout.}
Gout can strike any joint, but often affects those in the feet, such as the big toe,
and those in the legs. A gout attack can last several hours to a few days. Persons who
have gout can be symptom-free for years between attacks. Gout can be triggered by:
Mild trauma or blow to the joint
Drinking alcohol (beer and wine more than
distilled alcohol)
Taking certain medications (e.g., aspirin,
diuretics, and nicotinic acid)
Signs and Symptoms
Excruciating pain and
inflammation in a joint or joints that strike suddenly and peak quickly
Affected area that is swollen, red or
purplish in color, feels warm, and is very tender to the touch
Feeling of agonizing pain after even the
slightest pressure, such as rubbing a sheet against the affected area
Sometimes a low-grade fever
Sometimes chills and fever
Treatment and Care
Never assume you have gout without consulting a physician. Many conditions
can mimic an acute attack of gout. These include infection, injury, and rheumatoid
arthritis. Only a doctor can diagnose the problem.
If you do have gout, treatment will depend on the reasons behind your high levels of uric acid. Your doctor can conduct a simple test to tell if your kidneys aren't clearing uric acid from the blood the way they should or to find out if your body simply makes too much uric acid.
The first goal is to relieve the acute gout attack. The second goal is to prevent future attacks.
For immediate relief, your doctor will
prescribe colchicine, a nonsteroidal anti-inflammatory medication and/or other pain
reliever (not aspirin) and tell you to rest the affected joint.
For long-term relief, your doctor will
probably recommend that you lose excess weight, limit your intake of alcohol, drink lots
of liquids, and take medication, if necessary. One type of medication (allopurinol)
decreases uric acid production. Another (probenecid) increases the excretion of uric acid
from the kidneys.
(See "Places to Get Information & Help" under Arthritis.)
HEALTH AT HOME - Your Complete Guide to Symptoms, Solutions, and Self-Care © 1999 by Don R. Powell. American Institute for Preventive Medicine.
Date updated 04/21/99