Understanding Gout

Symptoms of Gou

Gout is a medical condition marked by swollen and painful joints, typically caused by the accumulation of uric acid or urate crystals in the affected area. Gout is more prevalent in men and frequently linked with obesity, hypertension, and diabetes.

During a gout attack, symptoms manifest swiftly and abruptly. Symptoms of gout include:

• Severe or intense pain in one or more affected joints, especially the big toe joint, as well as the midfoot, ankles, knees, fingers, wrists, and elbows.
• Redness and warm to touch.
• Swelling in and around the affected joint.
• Stiffness of the affected joint.

Symptoms can develop rapidly and last for 3 to 10 days. Gout attacks frequently recur in nearly all individuals, often within a year following the initial episode.

If an individual experiences intermittent and sudden joint pain, which is followed by symptom-free periods but the uric acid levels in the blood are persistently elevated, gout is highly suspected among various conditions causing joint pain and inflammation.

Risk Factors for Developing Gout

An individual with high levels of uric acid in the body is more likely to develop gout. There are several factors that increase the levels of uric acid level in the body.

Gout is more common in men aged between 30 and 45 whereas women become more susceptible to developing gout after the age of 55. However, gout is commonly seen among those older than 65, regardless of gender.

Regular consumption of large amounts of meat or seafood, excessive amounts of alcohol and beverages high in sugar also increases the levels of uric acid in the body.

Certain medical conditions, such as high blood pressure, diabetes, obesity, and chronic kidney disease, are associated with an increased risk of developing gout.

Other risk factors include obesity and taking medications that affect blood levels of urate, especially diuretics.

Diagnosis of Gout

Diagnosis is made based on your reported symptoms, physical examination, and investigations.

Your doctor would first question your general health and symptoms before conducting a thorough physical examination.

Your doctor will conduct a synovial fluid analysis whereby a small amount of synovial fluid is extracted from the affected joint using a needle and syringe. This fluid sample is then examined under a microscope to detect urate crystals.

Tophaceous gout can be diagnosed by sampling tophi, which are deposits of urate crystals beneath the skin, using a needle.

Blood test will also be conducted to measure the amount of uric acid in your blood or urine sample. Gout is usually associated with a high level of uric acid.

Gout can cause permanent joint damage if left untreated. Untreated gout can also significantly impact a person’s quality of life and increase the risk of long-term complications, including chronic gouty arthritis and joint deformity, which changes the shape of your joint; buildup of uric acid in the joints and soft tissue known as tophi (plural form of tophus), kidney damage, and increased cardiovascular disease risk.

Treatment Options for Gout

It is important to seek medical attention and follow appropriate treatment and lifestyle measures to manage the condition effectively. The objective of managing gout flares is to reduce inflammation safely and quickly, thus reducing pain and disability. Treatment is typically brief and focused on addressing the duration of the flare only.

Your doctor will prescribe anti-inflammatory medication such as nonsteroidal anti-inflammatory drugs (NSAIDs). Other types of medications include colchicine, and steroid medications known as glucocorticoids.

For long-term urate-lowering therapy (ULT), Allopurinol and Febuxostat are recommended for recurrent attacks of gout or complications of gout.

Making positive lifestyle changes can significantly decrease your risk of developing gout. Recommended changes include maintaining a healthy weight, engaging in regular exercise, avoiding purine-rich foods that contribute to uric acid production (such as red meat, oily fish, seafood, and products containing yeast extract), steering clear of sugary beverages and snacks, and ensuring adequate hydration by drinking more water.

Make an Appointment at Gleneagles Hospitals

If you suspect you may have gout, get in touch with us to book an appointment today for a consultation, or visit our Rheumatology Department at your nearest Gleneagles Hospital.