Gout

One of the most painful forms of arthritis, gout affects approximately 840 out of every 100,000 people. The disease occurs when uric acid, which is normally dissolved in the blood and passed through the kidneys into the urine, builds up in the blood. A few symptoms of gout include a sudden onset of intense joint pain, stiffness in the joint, and redness and heat at the joint. Although there is no cure for gout, the disease can be controlled with medicines and certain lifestyle changes.

 

What Is Gout?

Gout is one of the most painful forms of arthritis. The term arthritis refers to more than 100 different rheumatic diseases that affect the joints, muscles, and bones, as well as other tissues and structures. Gout accounts for approximately 5 percent of all cases of arthritis.
 
Gout occurs in approximately 840 out of every 100,000 people. It is rare in children and young adults. Adult men, particularly those between the ages of 40 and 50, are more likely to develop gout than women, who rarely develop the disorder before menopause. People who have had an organ transplant are more susceptible to gout.
 

Gout, Uric Acid, and Hyperuricemia

Uric acid is a substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods. Normally, uric acid is dissolved in the blood and passed through the kidneys into the urine, where it is eliminated.
 
If the body increases its production of uric acid or if the kidneys do not eliminate enough uric acid from the body, increased levels of it build up in the blood. This condition is called hyperuricemia.
 
Hyperuricemia is not a disease and by itself is not dangerous. However, if excess uric acid crystals form as a result of hyperuricemia, gout can develop. This increased level of uric acid in the blood can also lead to:
 
  • Deposits of uric acid (called tophi) that look like lumps under the skin around the joints and at the rim of the ear
  • Kidney stones from uric acid crystals in the kidneys.
     

Gout Causes

Gout is caused when the levels of uric acid become so high that sharp crystals form inside the joint. These urate crystals cause inflammation. This combination of urate crystals in the joint and inflammation results in the signs and symptoms of gout.
 
While there is no one specific cause of gout, there are a number of factors that increase a person's chances of developing gout.
 
(Click Causes of Gout or Gout Risk Factors to learn more about specific risk factors for gout.)
 

Symptoms of Gout

When high levels of uric acid in the blood lead to deposits of uric acid inside a joint, a person can develop gout. Symptoms of gout may include:
 
  • Sudden onset of intense joint pain
  • Swelling in the joints
  • Extreme tenderness in the joint area
  • Redness and heat at the joint
  • Stiffness in the joint.
     
(Click Gout Symptoms for more information on these symptoms of gout.)
 

Diagnosing Gout

Gout may be difficult for healthcare providers to diagnose because the symptoms of gout may be vague, and they often mimic other conditions. Therefore, in order to make a gout diagnosis, the healthcare provider will ask a number of questions, perform a physical exam looking for signs and symptoms of gout, and recommend certain tests and procedures.
 
(Click Gout Diagnosis for more information on this topic, including conditions that may share similar symptoms with gout.)
 

Treatment for Gout

There is no cure for gout. However, people with gout can take medications and make certain lifestyle changes in order to keep gout under control. The goal of any of these prevention methods is to control uric acid in the blood -- keeping it below concentrations at which crystals can form. This can reduce both the discomfort caused by the symptoms of gout and long-term damage to the affected joints. Proper gout treatments can help prevent disability due to this condition.
 
(Click Gout Treatments for more information on how acute gout is treated, including specific medicines that may be used. Click Gout Prevention for strategies that have been found to be helpful in preventing gout.)
 

Diet for Gout

For people with gout, diet can play a role in causing a gout attack because foods high in purines will increase the amount of uric acid the body makes (see Gout Risk Factors). Therefore, the primary gout diet recommended is a low-purine diet. Also, eating more low-fat dairy products, which are low in purines, has been shown to decrease the chances of having a gout attack.
 
(Click Gout Diet or Foods That Cause Gout for more information.)
 

Stages of Gout

The four stages of gout are as follows:
 
  • Asymptomatic hyperurecemia
  • Acute gout (also known as acute gouty arthritis)
  • Interval or intercritical gout
  • Chronic tophaceous gout.
     
(Click Gout Stages for more information on each of these stages of gout.)
 

Gout Versus Pseduogout

Pseudogout is sometimes confused with gout because it produces similar symptoms of inflammation. However, with pseudogout, the deposits are made up of calcium phosphate crystals, not uric acid. Therefore, pseudogout is treated somewhat differently than gout.
Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD