Gout

A condition marked by increased levels of uric acid in the blood, joints, and tissue. The buildup of uric acid in the joints and tissues causes arthritis and inflammation.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Gout

Gout is a metabolic disorder which causes inflammation of the joints. In acute cases, some joints swell up within just a few hours and become very sensitive to pain.

The inflammation is triggered by tiny needle-shaped crystals of uric acid that build up mostly in the joints. These crystals may form if there is too much uric acid in the body. The inflammation normally goes away on its own within one to two weeks. The pain can be relieved by taking anti-inflammatory or pain-relieving medication.

Most people with gout experience acute attacks every now and then. Months or even years can pass between attacks. There are a number of options to prevent them. Some people already notice an improvement if they avoid certain foods and other possible triggers. Others need to take medication to reduce their uric acid levels over the long-term... Read more about Gout

What works? Research summarized

Evidence reviews

Systemic corticosteroids for acute gout

‐ there is no precise information about side effects and complications. Only a minority of the patients treated with the steroid oral prednisolone reported minor side effects.

Intra‐articular glucocorticoids for acute gout

This summary of a Cochrane review presents what we know from research about the effect of glucocorticoid injections (into affected joints) in people with acute gout. There were no trials that met our inclusion criteria, and no trials measuring the effect on pain, inflammation, the number of withdrawals due to adverse events, function, quality of life, treatment success and serious adverse events. Studies of glucocorticoid injections in other conditions that lead to joint pain suggest that this therapy may be well tolerated, relatively safe and effective in relieving pain.

Febuxostat for treating chronic gout

This summary of a Cochrane review represents what we know from research about the effect of febuxostat for treating chronic gout.

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Summaries for consumers

Systemic corticosteroids for acute gout

‐ there is no precise information about side effects and complications. Only a minority of the patients treated with the steroid oral prednisolone reported minor side effects.

What can I do on my own to prevent gout attacks?

Gout is caused by high uric acid levels. If there’s too much uric acid in our bodies, it can build up in joints and cause an acute gout attack. Some people manage to keep their levels of uric acid down by eating less meat, fish and seafood and drinking less alcohol. Uric acid is released when substances called purines are broken down. Purines are mainly produced inside the body, but they are also found in many different types of foods that we eat. Fish, meat and seafood are especially rich in purines. People with gout are sometimes advised to stick to a strict low-purine diet. But it’s not clear exactly how effective that kind of diet is.

Gout: When is long-term treatment with medication suitable?

Gout can't always be managed by changing your diet or drinking less alcohol. Medication that lowers uric acid levels may then be an option. Long-term treatment with this type of medicine is especially suitable for frequent gout attacks and complications such as kidney stones. Gout is caused by high uric acid levels. If uric acid levels in the blood are too high, uric acid crystals may start to form in the joints and trigger gout attacks. Having high uric acid levels for years can lead to complications and damage the joints. Acute gout can become chronic. But because this doesn't happen to everyone, experts disagree on when to start treatment with medication that lowers uric acid levels. This decision is also a personal one because the medication needs to be taken over a period of several years and it may have side effects or interact with other kinds of medicine. A doctor can help you to carefully consider the pros and cons of the treatment.

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Terms to know

Chondrocalcinosis (Pseudogout)
A condition often mistaken for gout that results from the deposit of calcium phosphate crystals (not uric acid crystals as in gout) in the joints and other tissues.
Hyperuricemia
The presence of elevated levels of uric acid in the blood.
Podagra
Gout in the big toe.
Purines
One of two chemical compounds that cells use to make the building blocks of DNA and RNA. Examples of purines are adenine and guanine. Purines are also found in meat and meat products. They are broken down by the body to form uric acid, which is passed in the urine. High levels of uric acid in the body may cause gout.
Rheumatologist
Doctors who diagnose and treat diseases of the bones, joints, muscles, and tendons, including arthritis and collagen diseases.
Tophi
Nodular masses of uric acid crystals that sometimes form in the soft tissue of people with chronic gout. Although tophi are most common around the fingers, elbows, and big toe, they can occur in virtually any part of the body. (The singular is tophus.)
Uric Acid
A substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods.

More about Gout

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See Also: Arthritis

Other terms to know: See all 7
Chondrocalcinosis (Pseudogout), Hyperuricemia, Podagra

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