Recognize Gout Signs and Symptoms

Paying Attention to Gout Symptoms Leads to Proper Treatment

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Gout symptoms can develop when there is excess uric acid in the body. Monosodium urate crystals that form in the joints due to excess uric acid cause gout to develop. Uric acid is a waste product normally present in the blood as a result of the breakdown of purines. Purines are part of all human tissue and are found in many foods. Eating foods high in purines can raise uric acid levels in the blood and precipitate gout attacks in some people.

Excess uric acid in the blood, referred to as hyperuricemia, is caused by increased uric acid production in the body or inadequate elimination of uric acid from the body. It's important to recognize the signs and symptoms associated with gout, so that recurring gout attacks can be prevented or properly treated. About one in 100 people are affected by gout and perhaps as many as 7 percent of older men.

Recognizing Gout Symptoms

Gouty arthritis is a term used to describe painful, recurring attacks of joint inflammation. Generally, there are three stages of gout. Some medical literature counts a fourth stage as the period between gout attacks. The three stages are:

  • Asymptomatic hyperuricemia - Elevated blood uric acid occurs without symptoms of gout.
  • Acute intermittent gout - One joint becomes inflamed and painful, typically lasting for about 2 weeks if untreated and less if treated. Symptoms may not recur for weeks, months or years.
  • Chronic tophaceous gout - The affected joint becomes more frequently inflamed and uncomfortable. More than one joint may be affected at this stage. Crystals may collect and form tophi which are lumps underneath the skin. The development of kidney stones is also possible at this stage.

During the acute intermittent stage, the big toe is most commonly involved.

Any joint may be involved though. The affected joint typically is shiny and red, swollen, warm, and extremely painful.

Gout is more common in men, women after menopause, and people with kidney disease. Gout has been linked to obesity, hypertension, hyperlipidemia, and diabetes. There may be genetic factors involved since gout tends to run in families.

The Typical Gout Attack

  • The onset of a gout attack is usually quick. Often gout symptoms (warmth, swelling, redness, and pain) begin during the night.
  • Over an 8 to 12 hour period the pain level worsens, going from mere twinges to intense pain.
  • The big toe is affected in 90 percent of people with gout. Midfoot, ankles, heels, and knees are fairly common sites too, with wrists, fingers, and elbows being less common.
  • Walking is difficult when a gout attack affects lower extremities.
  • Fever, chills, and malaise (i.e., not feeling well) may also accompany acute gout attacks.

The goal of gout treatment is to minimize or prevent future gout attacks. Early treatment, when initial gout symptoms occur, and lifestyle modifications are important measures to take.

Lifestyle modifications can include losing weight, following an anti-inflammatory diet, and decreasing alcohol intake, if not avoiding it altogether. People who experience infrequent gout attacks may be tempted to ride it out and disregard the potential severity. There is no cure for gout. Symptoms must not be ignored and effort must go into managing the disease, otherwise gout attacks may become more frequent and more severe.

Sources:

Gout Fact Sheet. American College of Rheumatology. April 2015.
http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Gout

Gout - What Is It? Arthritis Foundation. Accessed 04/25/16.
http://www.arthritis.org/about-arthritis/types/gout/what-is-gout.php

Gout. Primer on the Rheumatic Diseases. Thirteenth edition. Arthritis Foundation.

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