Gout

gout animation:

Gout is caused by increased production of uric acid. As it spreads throughout the body, uric acid crystallizes in the joints. This results in pain and swelling. Watch the animation to learn more.





Gout

Also called: Gouty arthritis
Gout is a common, painful form of arthritis. It causes swollen, red, hot and stiff joints. Gout occurs when uric acid builds up in your blood. This happens if your body produces extra acid or does not eliminate enough, or if you eat too many foods with purines, such as liver and dried beans. Pseudogout has similar symptoms and is sometimes confused with gout. However, it is caused by calcium phosphate, not uric acid.

Often, gout first attacks your big toe. It can also attack ankles, heels, knees, wrists, fingers and elbows.

You are more likely to get gout if you

Are a man
Have family member with gout
Drink alcohol
At first, gout attacks usually get better in days. Eventually, attacks last longer and occur more often. Uric acid buildup can lead to kidney stones. Untreated gout can cause permanent joint and kidney damage. You can treat gout with medicines.
What Is Gout?

Gout is one of the most painful forms of arthritis. It occurs when too much uric acid builds up in the body. The buildup of uric acid can lead to:

Sharp uric acid crystal deposits in joints, often in the big toe
Deposits of uric acid (called tophi) that look like lumps under the skin
Kidney stones from uric acid crystals in the kidneys.
For many people, the first attack of gout occurs in the big toe. Often, the attack wakes a person from sleep. The toe is very sore, red, warm, and swollen.

Gout can cause:

Pain
Swelling
Redness
Heat
Stiffness in joints.
In addition to the big toe, gout can affect the:

Insteps
Ankles
Heels
Knees
Wrists
Fingers
Elbows.
A gout attack can be brought on by stressful events, alcohol or drugs, or another illness. Early attacks usually get better within 3 to 10 days, even without treatment. The next attack may not occur for months or even years.

What Causes Gout?

Gout is caused by the buildup of too much uric acid in the body. Uric acid comes from the breakdown of substances called purines. Purines are found in all of your body's tissues. They are also in many foods, such as liver, dried beans and peas, and anchovies.

Normally, uric acid dissolves in the blood. It passes through the kidneys and out of the body in urine. But uric acid can build up in the blood when:

The body increases the amount of uric acid it makes.
The kidneys do not get rid of enough uric acid.
A person eats too many foods high in purines.
When uric acid levels in the blood are high, it is called hyperuricemia. Most people with hyperuricemia do not develop gout. But if excess uric acid crystals form in the body, gout can develop.

You are more likely to have gout if you:

Have family members with the disease
Are a man
Are overweight
Drink too much alcohol
Eat too many foods rich in purines
Have an enzyme defect that makes it hard for the body to break down purines
Are exposed to lead in the environment
Have had an organ transplant
Use some medicines such as diuretics, aspirin, cyclosporine, or levodopa
Take the vitamin niacin.
How Is Gout Diagnosed?

Your doctor will ask about your symptoms, medical history, and family history of gout. Signs and symptoms of gout include:

Hyperuricemia (high level of uric acid in the blood)
Uric acid crystals in joint fluid
More than one attack of acute arthritis
Arthritis that develops in 1 day, producing a swollen, red, and warm joint
Attack of arthritis in only one joint, usually the toe, ankle, or knee.
To confirm a diagnosis of gout, your doctor may draw a sample of fluid from an inflamed joint to look for crystals associated with gout.

How Is Gout Treated?

Doctors use medicines to treat an acute attack of gout, including:

Nonsteroidal anti-inflammatory drugs (NSAIDs)
Corticosteroids, such as prednisone
Colchicine, which works best when taken within the first 12 hours of an acute attack.
Sometimes doctors prescribe NSAIDs or colchicine in small daily doses to prevent future attacks. There are also medicines that lower the level of uric acid in the blood.

What Can People With Gout Do to Stay Healthy?

Some things that you can do to stay healthy are:

Take the medicines your doctor prescribes as directed.
Tell your doctor about all the medicines and vitamins you take.
Plan followup visits with your doctor.
Maintain a healthy, balanced diet. Avoid foods that are high in purines, and drink plenty of water.
Exercise regularly and maintain a healthy body weight. Ask your doctor about how to lose weight safely. Fast or extreme weight loss can increase uric acid levels in the blood.
What Research Is Being Done on Gout?

Scientists are studying:

Which NSAIDs are the most effective treatments for gout
Optimal dosages of medications for gout
New medicines that safely lower uric acid in the blood and reduce symptoms
New therapies that block a chemical called tumor necrosis factor
Enzymes that break down purines in the body
The role of foods and certain vitamins
The role of genetics and environmental factors
The interactions of cells involved in acute gout attacks.
Scientists are also studying the role of genetics and environmental factors in hyperuricemia and gout.

For More Information on Gout and Other Related Conditions:

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892–3675
Phone: 301–495–4484 or 877–22–NIAMS (226–4267) (free of charge)
TTY: 301–565–2966
Fax: 301–718–6366
E-mail: NIAMSInfo@mail.nih.gov
www.niams.nih.gov

The information in this publication was summarized in easy-to-read format from information in a more detailed NIAMS publication. To order the Gout Q&A full-text version, please contact NIAMS using the contact information above. To view the complete text or to order online, visit http://www.niams.nih.gov.

For Your Information

This publication contains information about medications used to treat the health condition discussed here. When this publication was printed, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.