Gout is a form of arthritis where uric acid crystals form in the joints causing pain and discomfort. Robert Mair reports.

In this article:

  • What is gout?
  • Symptoms
  • Risk factors
  • Treatment

What is gout?

Gout is a condition that causes sudden and severe pain and swelling in the joints. It affects one in 200 adults – mainly men – and the symptoms can last up to 10 days.

Gout is caused by a buildup of uric acid (also known as urate). Uric acid is normally harmless, occurring naturally in the body, where it is used to break down substances called purines.

Purines also occur naturally in the body, but they are also found in food and drink. To break down the purines, the body produces uric acid, which then passes through the kidneys where it is normally excreted as urine.

However, if too much uric acid is produced – or too little excreted – it can attach itself to joints in the form of sharp crystals. These crystals are the cause of gout, resulting in inflammation and soreness around the affected joint.

Gout usually affects the big toe, but can also affects the following joints:

  • Knees
  • Ankles
  • Heels
  • Fingers
  • Wrists
  • Elbows

It can affect more than one joint at the same time – and can cause excruciating pain.

Symptoms

Although gout is a common condition, it is hard to predict when an attack will occur. But there are several tell-tale signs that can signify a gout attack. These include:

  • Inflammation and swelling
  • Red, shiny skin over the affected joint
  • Itchy flaky skin over the affected joint

The pain caused by gout can make walking difficult, and even a light duvet covering the affected area can cause intense discomfort.

A gout attack can last for up to 10 days, after which the joint should become pain-free. But if the condition is left untreated future attacks can be more intense and prolonged.

Risk factors

In the UK approximately 1 in 70 adults have gout. There are a number of different risk factors associated with gout, but specific lifestyles can increase the risks. For example:

  • A purine-rich diet. Purines can be found in anchovies, herring, liver, kidneys and foods high in yeast. Beers, stouts and spirits are also high in purines.
  • Being overweight or obese. Being overweight can lead to an increase in uric acid levels.

Men are at far greater risk of gout than women and we are also more at risk as we age. Several medical conditions also increase the chance of getting gout, including:

  • Psoriasis
  • Hypertension
  • Diabetes
  • Blocked or narrowed arteries
  • High fat and cholesterol levels in the blood
  • Long term kidney problems, kidney failure or reduced kidney function

Gout often runs in families and the likelihood of experiencing an attack is increased if a close family member has suffered from the condition previously.

Treatment

There are a number of treatments available to people suffering from gout.

The joint should be elevated and rested as much as possible to relieve the symptoms. Ice wrapped in a towel and applied to the affected joint can also relieve the pain.

Alcohol should also be avoided, as this can potentially aggravate the symptoms.

Anti-inflammatory drugs may be prescribed to reduce the swelling.

When medication is taken as directed by a healthcare professional, coupled with improvements in diet and reducing the amount of alcohol you drink, many peoples uric acid levels reduce sufficiently allowing the body to dissolve the crystals which cause gout itself.