Gout is caused by having higher-than-normal levels of uric acid in your body. This may occur if:
Your body makes too much uric acid
Your body has a hard time getting rid of uric acid
If too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed.
The exact cause is unknown. Gout may run in families. It is more common in men, in women after menopause, and those who drink alcohol. People who take certain medicines, such as hydrochlorothiazide and other water pills, may have higher levels of uric acid in the blood.
Not everyone with high uric acid levels in the blood has gout.
Medicines should be taken as soon as possible if you have a sudden gout attack.
Take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or indomethacin as soon as your symptoms begin. Talk to your health care provider about the correct dose. You will need stronger doses for a few days.
Your health care provider may prescribe strong painkillers such as codeine, hydrocodone, and oxycodone.
A prescription medicine called colchicine helps reduce pain, swelling, and inflammation.
Corticosteroids can also be very effective. Your doctor may inject the inflamed joint with steroids to relieve the pain.
The pain often goes away within 12 hours of starting treatment, and is completely relieved in 48 hours.
Daily use of allopurinol or probenecid decrease uric acid levels in your blood. Your doctor may prescribe these medicines if:
You have several attacks during the same year or your attacks are quite severe
You have damage to joints
You have tophi
You have uric acid kidney stones
Some diet and lifestyle changes may help prevent gouty attacks:
Reduce how many purine-rich foods you eat, especially anchovies, sardines, oils, herring, organ meat (liver, kidney, and sweetbreads), legumes (dried beans and peas), gravies, mushrooms, spinach, asparagus, cauliflower, consommé, and baking or brewer's yeast.
Limit how much meat you eat at each meal.
Avoid fatty foods such as salad dressings, ice cream, and fried foods.
Eat enough carbohydrates.
If you are losing weight, lose it slowly. Quick weight loss may cause uric acid kidney stones to form.
Call for an appointment with your health care provider if you have symptoms of acute gouty arthritis.
The disorder itself may not be preventable, but you may be able to avoid things that trigger your symptoms. Limit alcohol consumption and follow a low-purine diet.
Wilson JF. In the clinic. Gout. Ann Intern Med. 2010 Feb 2;152(3):ITC21.
Richette P, Bardin T. Gout. Lancet. 2010 Jan 23;375(9711):318-28.
Ariel D. Teitel, M.D., M.B.A., Chief, Division of Rheumatology, St. Vincent’s Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.