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Fizza Mahmood
21 May 2024
Gout occurs due to the build of uric acid in the blood and accumulating in a joint causing pain and swelling. It is a periodic condition which comes and goes thus it is important to learn what it is, its symptoms and causation factors to better manage the condition. Explore its diagnosis, treatment and prevention options.
Gout is a complex condition in which sudden, severe attacks of pain and swelling, redness and tenderness of the joints occurs. It is a form of arthritis caused by the build up of uric acid in the areas around the joint. This causes inflammation and pain. The big toe is the most commonly affected joint, however it can also affect the hands, wrists, knees, ankles and elbows.
The symptoms are usually pain in joints which can be quite severe. The area of pain can get swelling and redness which can feel tender and warm. These symptoms can restrict the movement of the joint which results in joint pain. A gout attack develops quickly and may last up to 1-2 weeks.
Uric acid is a normal waste product generally found in our blood. It is broken down from cells, DNA, and the diet we consume. The buildup happens when kidneys do not excrete enough or when too much uric acid is being produced.
This excess production forms uric acid crystals in the joints. It is these crystals which cause sudden and severe inflammation in the joints.
There are some genetic related risk factors and some lifestyle factors which increase the risk of gout. Being older than 65 years, having a family history of gout, having high levels of uric acid in the blood, in postmenopausal women, and is generally more common in males.
The risk of developing the symptoms may be more likely in those who are overweight, or believe in crash dieting and fasting for long intervals. It can occur in individuals who drink alcohol and consume a lot of red meat or shellfish.
Individuals with impaired kidney function may also face this problem, as uric acid is excreted from the kidneys. Individuals who may be on diuretic medicine can also be at risk. Alongside those with high blood pressure or other health conditions. Dehydration can also be a contributing risk factor.
A healthcare professional will diagnose gout after a physical exam and based on the symptoms and review of medical history. The description of joint pain, how often and intensely the pain is, and how red/swollen the area becomes will help determine the severity. A sample of fluid around the joint can be tested to see the buildup of uric acid. Performing an X-ray will show if there is any joint damage.
The treatment aim for gout is in two parts: to treat the acute attack and to prevent a future attack. The main treatment includes pain-relieving medicine, usually non-steroidal anti-inflammatory (NSAIDs). The treating doctor may prescribe other medicines to relieve the pain and swelling quickly.
It is important to receive prompt treatment to relieve the symptoms, otherwise, they can last up to a week and cause complications. Some of the complications could be kidney stones, kidney damage, and recurrent attacks can cause irreversible damage.
Symptoms can be very uncomfortable, and some relief can be applied at home immediately. Applying ice to the joint and elevating the joint can ease the pain.
The aim for people with gout is to lower their uric acid levels to reduce the risk of attacks. Certain foods like ginger, celery, cherries and drinks such as diluted apple cider vinegar and specific teas can help lower uric acid.
If individuals experience recurrent attacks, they can benefit from prescription medicines such as allopurinol which lower uric acid levels in the blood. This will help prevent an attack or at least minimise the affects of an attack when it occurs. People can reduce their chances of having further attacks by adopting some lifestyle changes:
Individuals should consult a doctor for any sudden or intense pain in any joint, especially if there is swelling or redness too. This could be because gout symptoms can mask the symptoms of infections, which would need to be treated immediately. It is essential for those experiencing frequent gout attacks or more severe ones to have a thorough discussion with their doctor about managing their diagnosis and the most beneficial gout treatment for them.
Gout Symptoms, Medications, & Causes | Musculoskeletal Australia (msk.org.au)
Gout Symptoms, Causes & Diet Recommendations | NIAMS (nih.gov)
Fizza is a registered pharmacist with APHRA and has been with Simple Online Doctor since 2023. With a Bachelor of Pharmacy and 8 plus years of experience as a pharmacist, Fizza has a strong passion to improve patient care via enhancing the quality and continuity of care delivered through digital health platforms.
Tyson is a clinical pharmacist in charge of the development and improvement of patient services. He provides clinical support to our team of healthcare professionals and ensures patient health and wellbeing are at the centre of all our services.
Last Reviewed : 21/05/2024
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