Gout: Causes and Treatment

Gout attacks cause excruciating pain and recurrent attacks that bring about permanent joint and tendon damage. Find out more the causes and gout treatments.

Gout attacks can limit your daily activities and even cause permanent joint and tendon damage. Here is all you need to know about this chronic disease.

What is Gout and Gout Attacks?

Gout is a chronic disease with intermittent painful arthritis, commonly in the big toes, foot, ankles or knees. Gout attacks are episodes of sudden pain in the joint, which rapidly becomes red, hot, swollen and painful, with severe limitation in joint function (such as walking). Initially, gout attacks usually affect one joint with complete resolution of symptoms between attacks. At later stages, gout attacks can involve multiple joints, including those in the upper limbs.

What Causes Gout?

Uric acid is produced in the body during the breakdown of purines, which are chemical compounds naturally found in your body, as well as food and drinks. Gout is caused by an excess of uric acid in the blood (hyperuricaemia). Uric acid may form crystals that build up in joints and tissues, resulting in inflammation and intense pain. Chronic deposition of uric acid crystals leads to visible lumps called tophi.

Who Does Gout Affect?

Gout affects mostly men, starting in their 30s, and the risk increases with age. It is less common in women until they reach menopause. Gout is often associated with other medical conditions such as kidney disease, high blood pressure, obesity and heart disease. Often, patients have family members affected by gout. Diets rich in meat, seafood, and alcohol also predispose a person to gout.

Why Should We Treat Gout?

Gout can be easily managed with medication and lifestyle modifications. Gout attacks cause excruciating pain, limit daily activities, including walking, and tremendously affect your work and social life, as well as mood. Recurrent attacks of gout may cause permanent damage to the joints and tendons. In addition, high uric acid levels can lead to kidney stones and kidney problems, increased risk of heart disease and increased cardiovascular mortality. 

You can manage gout by making lifestyle changes, such as maintaining a healthy weight and exercising regularly. In addition, drink six to eight glasses of water a day and maintain a well-balanced diet. Food and drinks to avoid include alcohol (especially beer), fruit juices and soft drinks, as well as meat, animal organs and seafood.

Gout Treatments

Acute gout attacks are treated with medications, such as:

  • Colchicine
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), for example, naproxen, diclofenac and indomethacin
  • Corticosteroids, such as oral prednisolone or steroid injection into affected joints

It is important to note that not all the medications above are suitable for every patient. Factors such as drug allergies and kidney disease may mean that certain medications need to be avoided. Do consult your doctor for the appropriate treatment.

Reduction of uric acid is the mainstay of gout treatment and will reduce attacks. A good target uric acid level is less than 360 micromoles per litre (µmol/L), or 300µmol/L in patients who have tophi. Medications such as allopurinol, febuxostat or probenecid can be used. Again, the doctor will review your medical background to decide on the most suitable medication for you.

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