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Gout is a kind of arthritis. It can cause an attack of sudden burning pain, stiffness, and swelling in a joint, usually a big toe. These attacks can happen over and over unless gout is treated. Over time, they can harm your joints, tendons, and other tissues. Gout is most common in men.
Gout is caused by too much uric acid in the blood. Usually, having too much uric acid isn't harmful. Many people with high levels in their blood never get gout. But sometimes when these levels in your blood are too high, the uric acid forms hard crystals in your joints.
The most common sign of gout is a nighttime attack of swelling, tenderness, redness, and intense pain in a joint, usually your big toe joint. It may get worse quickly and last for hours, a few days, or even weeks. Gout can affect how much you can move the affected the joint.
To diagnose gout, your doctor may take a sample of fluid from your joint to look for uric acid crystals. This is the best way to test for gout. Your doctor may also do a blood test to measure the amount of uric acid in your blood and do imaging tests, such as ultrasound.
Medicines can help treat gout. To stop a gout attack, your doctor will prescribe pills such as colchicine or NSAIDs (such as naproxen). Sometimes it's treated with a steroid shot. The sooner you get started on medicines, the sooner your symptoms will start to get better.
Resting the joint that hurts can also help you feel better. Taking ibuprofen or another anti-inflammatory medicine can help too. Using ice on the sore joint may also help.
To manage long-term gout and prevent future attacks, your doctor can prescribe a medicine to reduce uric acid buildup in your blood. For the first few months you will probably take another medicine with it to prevent attacks until the long-term medicine has time to work.
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Gout is caused by too much uric acid in the blood (hyperuricemia). Most of the time, having too much uric acid isn't harmful. Many people with high levels in their blood never get gout. But sometimes when these levels in your blood are too high, the uric acid forms hard crystals in your joints. This causes pain and other symptoms.
In some cases, the exact cause isn't known. But inherited factors (genes) seem to play a role.
Gout can seem to flare up without specific cause. Or it can be brought on by:
Symptoms of gout include:
Gout can also affect the joints of the feet, ankles, knees, wrists, fingers, and elbows.
Gout attacks can last a few days or many weeks before the pain goes away.
Gout most often occurs after a number of years of buildup of uric acid crystals in the joints and tissues. A gout attack usually starts during the night with moderate pain that grows worse. Symptoms usually occur in a single joint, most often the big toe. Then symptoms go away over time.
Most gout attacks stop after about a week. But severe attacks may last up to several weeks, with soreness lasting for up to 1 month. Many people have a second attack of gout within 6 months to 2 years after their first attack. But there may be many years between attacks. If gout is untreated, the frequency of attacks usually increases with time.
Call or see your doctor now if you have:
It's important to see your doctor even if the pain from gout has stopped. The uric acid buildup that caused your gout attack may still be irritating your joints. It could cause serious damage over time. Your doctor can prescribe medicines that can prevent and even reverse the uric acid buildup.
To diagnose gout, your doctor may do:
While X-rays of feet and hands are sometimes useful in the late stages of gout, X-rays aren't usually helpful in the early diagnosis. Pain often causes people to seek medical care before any long-term changes can be seen on an X-ray. But X-rays may help to rule out other causes of arthritis.
The goals of treatment for gout are fast pain relief and preventing future gout attacks and long-term problems. These include joint destruction and kidney damage.
Specific treatment depends on whether you are having an acute attack or are trying to manage long-term gout and prevent future attacks.
To stop a gout attack, your doctor will give you medicines. These are usually pills like colchicine, NSAIDs (such as naproxen), or a steroid medicine. Sometimes it's treated with a steroid shot. The sooner you get started on medicines, the sooner your symptoms will start to get better.
To ease the pain during a gout attack, rest the joint that hurts. Taking ibuprofen or another anti-inflammatory medicine can also help you feel better. Using ice on the sore joint may also help.
Gout symptoms can come and go for several years. And they may affect more than one joint.
To manage long-term gout and prevent future attacks, your doctor can prescribe a medicine like a xanthine oxidase inhibitor (such as allopurinol) to reduce uric acid buildup in your blood.
The medicine may also reduce tophi if you have them. Tophi are chalky nodules that form from uric acid crystals. They may first appear as nodules on the hands, elbows, or ears. In rare cases, surgery may be done to remove large tophi that are causing deformity.
While you are starting long-term medicine, your doctor will probably also prescribe colchicine or NSAIDs for the first several months. This helps prevent attacks until the long-term medicine has time to work.
Medicines are used to treat gout attacks and to reduce uric acid in the blood.
Both short-term and long-term medicines may be used.
These relieve pain and reduce inflammation during an acute attack or prevent acute attacks from coming back.
They may include:
Medicines, such as allopurinol, lower uric acid levels in the blood. This can reduce how often you have gout attacks and how bad they are.
If your doctor prescribes medicine to lower uric acid levels, take it as directed. Most people will continue to take this medicine every day. Make sure you know how to take it.
Current as of: December 20, 2021
Author: Healthwise StaffMedical Review: Anne C. Poinier MD - Internal MedicineE. Gregory Thompson MD - Internal MedicineMartin J. Gabica MD - Family MedicineKathleen Romito MD - Family MedicineMary F. McNaughton Collins MD, MPH - Internal Medicine
Current as of: December 20, 2021
Author: Healthwise Staff
Medical Review:Anne C. Poinier MD - Internal Medicine & E. Gregory Thompson MD - Internal Medicine & Martin J. Gabica MD - Family Medicine & Kathleen Romito MD - Family Medicine & Mary F. McNaughton Collins MD, MPH - Internal Medicine
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