Gout is a form of crystalline-arthritis which can cause swelling and pain in the joints. The most common locations for gout initially include the foot (especially the base of the big toe) and ankle. In time, other joints and surrounding tendons may be involved including the knee, wrist, elbow and hand joints. Gout is known as an “acute” arthritis, meaning that the symptoms often start very quickly and usually can last up to 7-10 days. In between episodes, patient’s often feel well.

Gout can develop in some people who have elevations in a substance called uric acid in the blood. The uric acid can form crystals that may deposit in different locations in the body (such as joints, but even in the kidney leading to kidney stones). The symptoms of gout occur when the normal circulating white blood cells in the joint lining recognize the crystals as foreign material and engulf it. Then, chemical signals are released and the inflammatory cascade is initiated, which leads to the pain, swelling and redness seen in gout attacks.

Gout usually develops in adulthood. It is more common in men, often between the ages of 30-55, and occurs later in women (usually after menopause). Not everyone with high levels of uric acid will develop gout.

Risk Factors of Gout

Risk factors for gout can include obesity, chronic kidney disease, increased alcohol intake, eating large amounts of meat or seafood, drinking beverages containing high fructose corn syrup (such as non-diet sodas), taking medications that affect blood levels of uric acid (especially diuretics). In patients with established gout, there are triggers that may lead to repeat gout flares which include:

• Consuming high purine foods/drinks such as: red meat, pork, organ meats, shellfish, certain types of fish (such as sardines, anchovies, trout, herring), beer

• Dehydration

• Recent injury or illness

• Fasting

Gout Treatment

Treatment of gout is divided into 3 parts. The first is to avoid any dietary triggers, the second is to treat any acute gout attacks (usually colchicine, non-steroidal anti-inflammatory drugs or steroids), and the third is to prevent gout flares by using uric acid lowering medications in select patients who meet certain criteria. Dr. Jain will take a thorough history and exam, and may perform an arthrocentesis (removing fluid from the joint for analysis to confirm gout) along with lab work in order to develop a management plan for the treatment of gout. Schedule an appointment with Dr. Jain, rheumatologist and gout specialist →

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