Gout
Symptoms of gout
Some people have too much uric acid in their blood, but no symptoms. This is called asymptomatic gout.
For acute gout, symptoms come on quickly from the buildup of uric acid crystals in your joint and last for 3 to 10 days.
You’ll have intense pain and swelling, and your joint may feel warm. Between gout attacks you won’t have any symptoms.
If you don’t treat gout, it can become chronic. Hard lumps called tophi can eventually develop in your joints and the skin and soft tissue surrounding them. These deposits can permanently damage your joints.
Prompt treatment is important to prevent gout from turning chronic.
Causes of gout
The buildup of uric acid in your blood from the breakdown of purines causes gout.
Certain conditions, such as blood and metabolism disorders or dehydration, make your body produce too much uric acid.
A kidney or thyroid problem, or an inherited disorder, can make it harder for your body to remove excess uric acid.
You’re more likely to get gout if you:
- are a middle-aged man or postmenopausal woman
- have parents, siblings, or other family members with gout
- drink alcohol
- take medications such as diuretics and cyclosporine
- have a condition like high blood pressure, kidney disease, thyroid disease, diabetes, or sleep apnea
Gout diagnosis
Your doctor can diagnose gout based on a review of your medical history, a physical exam, and your symptoms. Your doctor will likely base your diagnosis on:
- your description of your joint pain
- how often you’ve experienced intense pain in your joint
- how red or swollen the area is
Your doctor may also order a test to check for a buildup of uric acid in your joint. A sample of fluid taken from your joint can show whether it contains uric acid. The doctor may also want to take an X-ray of your joint.
If you have symptoms of gout, you can start with a visit to your primary care doctor.
Treatment of gout
If left untreated, gout can eventually lead to arthritis. This painful condition can leave your joint permanently damaged and swollen.
The treatment plan your doctor recommends will depend on the stage and severity of your gout.
Medications to treat gout work in one of two ways: They relieve pain and bring down inflammation, or they prevent future gout attacks by lowering uric acid levels.
Drugs to relieve gout pain include:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (Bufferin), ibuprofen (Advil, Motrin), and naproxen (Aleve)
- colchicine (Colcrys, Mitigare)
- corticosteroids
Drugs that prevent gout attacks include:
- xanthine oxidase inhibitors, such as allopurinol (Lopurin, Zyloprim) and febuxostat (Uloric)
- probenecid (Probalan)
Along with medications, your doctor may recommend lifestyle changes to help manage your symptoms and reduce your risk of future gout attacks. For example, the doctor may encourage you to:
- reduce your alcohol intake
- lose weight
- quit smoking
Medications and lifestyle changes aren’t the only way to manage gout.
Gout foods to avoid
Certain foods are naturally high in purines, which your body breaks down into uric acid. Most people don’t have a problem with high-purine foods. But if your body has trouble releasing excess uric acid, you may want to avoid certain foods and drinks, such as:
- red meats
- organ meats
- certain seafood
- alcohol
Sugar-sweetened beverages and foods containing the sugar fructose can also be problematic, even though they don’t contain purines.
Certain foods help reduce uric acid levels in the body.
Gout home remedies
Some gout-relief methods don’t come in a bottle from your pharmacy. Evidence from studies suggests that these natural remedies may help lower uric acid levels and prevent gout attacks:
- tart cherries
- magnesium
- ginger
- apple cider vinegar
- celery
- nettle tea
- dandelion
- milk thistle seeds
But simply eating these foods may not be enough to tame gout.
Gout surgery
Gout can typically be treated without surgery. But after many years, this condition can damage the joints, tear the tendons, and cause infections in the skin over the joints.
Hard deposits, called tophi, can build up on your joints and in other places, like your ear. These lumps may be painful and swollen, and they can permanently damage your joints.
Three surgical procedures treat tophi:
- tophi removal surgery
- joint fusion surgery
- joint replacement surgery
Which one of these surgeries your doctor recommends depends on the extent of the damage, where the tophi are located, and your personal preferences.
Gout triggers
Certain foods, medications, and conditions can set off gout symptoms. You may need to avoid or limit foods and drinks like these, which are high in purines:
- red meat, such as pork and veal
- organ meats
- fish, such as cod, scallops, mussels, and salmon
- alcohol
- sodas
- fruit juice
Some medications you take to manage other conditions increase the level of uric acid in your blood. Talk to your doctor if you take any of these drugs:
- diuretics, or water pills
- aspirin
- blood pressure-lowering medications, such as beta-blockers and angiotensin II receptor blockers
Your health may also be a factor in flare-ups. All of these conditions have been linked to gout:
- obesity
- diabetes or prediabetes
- dehydration
- joint injury
- infections
- congestive heart failure
- high blood pressure
- kidney disease
Sometimes it can be hard to pinpoint which of these factors is behind your gout attacks.
Gout prevention
Here are a few steps you can take to help prevent gout:
- Limit how much alcohol you drink.
- Limit how much purine-rich food, such as shellfish, lamb, beef, pork, and organ meat, you eat.
- Eat a low-fat, nondairy diet that’s rich in vegetables.
- Lose weight.
- Stop smoking.
- Exercise.
- Stay hydrated.
Gout essential oils
Essential oils are plant-based substances used in aromatherapy. Some oils are thought to have anti-inflammatory, pain relieving, and antibacterial effects.
Some of the essential oils used to treat gout include:
- lemongrass oil
- celery seed oil
- yarrow oil extract
- olive leaf extract
- Chinese cinnamon
You can either breathe in these oils, rub the diluted oil on your skin, or make a tea from the dried leaves of the plant. Just don’t put the oils themselves into your mouth. They’re not safe to ingest.
It’s always a good idea to check with your doctor before you use any alternative therapy, even one that’s generally considered safe, like essential oils.
Is gout hereditary?
Gout is at least partly due to heredity. Researchers have found dozens of genes that increase people’s susceptibility to gout, including SLC2A9 and ABCG2. Genes associated with gout affect the amount of uric acid the body holds onto and releases.
Because of genetic factors, gout runs in families. People with a parent, sibling, or other close relative who has gout are more likely to get this condition themselves.
It’s likely that genes only set the stage for gout. Environmental factors, such as diet, actually trigger the disease.
Gout and alcohol
Alcohol, like red meat and seafood, is high in purines. When your body breaks down purines, the process releases uric acid.
More uric acid increases your risk of having gout. Alcohol can also reduce the rate at which your body removes uric acid.
Not everyone who drinks will develop gout. But a high consumption of alcohol (more than 12 drinks per week) can increase the risk — especially in men. Beer is more likely than liquor to influence the risk.
In surveys, people have reported that drinking alcohol triggers their gout flare-ups.