Where is gout common

Gout can be difficult to diagnose because the symptoms may mimic those of other conditions such as joint infection.

A blood sample may be taken to check for alterations in normal blood levels and a raised uric acid level. Results of this test may not always be helpful, however, as they often indicate normal uric acid levels during an attack of gout.

This is likely to be because the excess uric acid has moved out of the blood and has settled as crystals in the joints. To make a definitive diagnosis of gout the doctor may take a sample of fluid from the affected joint. This is performed using a local anaesthetic and involves inserting a needle inserted into the affected joint and removing a small amount of fluid.

The fluid is then sent to a laboratory where it is tested for the presence of uric acid crystals. If they are present, then gout is confirmed. X-rays of the affected area may also be taken to check for joint damage. Medical treatment is aimed at relieving the pain and inflammation of acute attacks and preventing the occurrence of future attacks. Diet and lifestyle changes also help to prevent future attacks of gout.

Treatment of acute attacks:. The more promptly that effective treatment is commenced, the more quickly the attack can be controlled. The different types of medications used include:. Drinking extra fluid preferably water while taking these medications is recommended. The affected joint should also be rested and elevated.

Preventing future attacks:. Preventing attacks of gout is as important as treating the symptoms of an acute attack. Ways in which gout can be prevented include use of medications and lifestyle changes. Medications — the mainstay drug for people with gout is allopurinol, which acts to reduce uric acid production. People who cannot take allopurinol because of side effects or other reasons may be prescribed alternative medications which either reduce uric acid production or increase the excretion of uric acid by the kidneys.

Home Illnesses and conditions Muscle, bone and joints Conditions Gout. Gout See all parts of this guide Hide guide parts 1. About gout 2. Symptoms of gout 3. Causes of gout 4. Diagnosing gout 5. Treating gout 6. Complications of gout. About gout Gout is a type of arthritis in which small crystals form inside and around the joints. It's estimated that between one and two in every people in the UK are affected by gout.

Signs and symptoms of gout Any joint can be affected by gout, but it usually affects joints towards the ends of the limbs, such as the toes, ankles, knees and fingers. Signs and symptoms of gout include: severe pain in one or more joints the joint feeling hot and very tender swelling in and around the affected joint red, shiny skin over the affected joint Symptoms develop rapidly over a few hours and typically last three to 10 days.

Almost everyone with gout will experience further attacks at some point, usually within a year. When to see your GP See your GP if you suspect you have gout and it hasn't been previously diagnosed, particularly if the pain keeps getting worse and you also have a high temperature fever. What causes gout? Gout is caused by a build-up of a substance called uric acid in the blood. Treatments for gout If you have gout, treatment is available from your GP to: relieve symptoms during an attack — this can be done using ice packs and by taking medications such as non-steroidal anti-inflammatory drugs NSAIDs , colchicine or corticosteroids prevent further attacks — through a combination of lifestyle changes, such as losing weight or changing your diet, and taking medication that lowers uric acid levels, such as allopurinol With treatment, many people are able to reduce their uric acid levels sufficiently to dissolve the crystals that cause gout — and as a result have no further attacks.

Can gout cause further problems? Sometimes gout can lead to further problems, particularly if it's left untreated. These can include: kidney stones small firm lumps of uric acid crystals under the skin called tophi permanent joint damage Read more about the complications of gout. What's pseudogout? Symptoms of gout The main symptom of gout is a sudden attack of severe pain in one or more joints, typically your big toe.

Other symptoms can include: the joint feeling hot and very tender, to the point of being unable to bear anything touching it swelling in and around the affected joint red, shiny skin over the affected joint peeling, itchy and flaky skin as the swelling goes down The intense pain can make getting around difficult. Which joints can be affected? Gout can affect almost any joint and can occur in more than one joint at the same time. The joints towards the ends of the limbs tend to be affected more often, including the: toes — particularly the big toe joint midfoot where your shoelaces sit ankles knees fingers wrists elbows If gout is left untreated, it's likely to affect more joints over time.

Pattern of symptoms Attacks of gout tend to: occur at night, although they can happen at any time develop quickly over a few hours last between three and 10 days — after this time, the affected joint should start to return to normal, but the problem can persist if treatment isn't started early come back — you may experience attacks every few months or years become more frequent over time if not treated It's difficult to predict how often attacks will occur and when exactly they will happen.

When to seek medical advice See your GP if you suspect you have gout and it hasn't been previously diagnosed.

Contact your GP immediately or call the service if you have both: severe, worsening joint pain and swelling a high temperature fever of 38C Causes of gout Gout is caused by small crystals forming in the joints, resulting in severe pain, tenderness and swelling.

Uric acid Uric acid is created when the body breaks down chemicals known as purines. What can increase your risk?

Other factors that may increase your risk of developing gout are outlined below. Medical conditions Some underlying medical conditions can increase your risk of developing gout, including: high blood pressure diabetes kidney disease high levels of fat and cholesterol in your blood obesity metabolic syndrome a combination of diabetes, high blood pressure and obesity psoriasis a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales osteoarthritis Medication Certain medications can increase your uric acid levels and your risk of developing gout.

These include: diuretics water tablets — used to treat high blood pressure or an abnormal build-up of fluid in your body certain medicines used to treat high blood pressure — including beta-blockers and ACE inhibitors low-dose aspirin — used to reduce the risk of blood clots niacin — used to treat high cholesterol ciclosporin — used to treat conditions such as psoriasis some chemotherapy medicines Diet Uric acid is created when the body breaks down purines.

Foods naturally high in purines include: red meat — such as beef, lamb and pork seafood — especially shellfish and oily fish offal — such as liver, kidneys and heart Alcohol Alcoholic drinks can raise the level of uric acid in the blood.

Sugary drinks Certain sugary drinks may also increase your risk of gout. Family history Studies have shown that gout often runs in families. Diagnosing gout Your GP may suspect gout based on your symptoms. Further tests Many conditions can cause gout-like symptoms.

Joint fluid test A sample of fluid may be taken from the affected joint. Blood test A blood test known as a serum uric acid test may be used to measure the amount of uric acid in your blood.

X-ray An X-ray is rarely used to diagnose gout because the condition isn't usually detectable using this method. Ultrasound scan An ultrasound scan of an affected joint is a simple and safe investigation that's increasingly used to detect crystals in the joints.

Treating gout Treatment for gout includes pain relief to help you cope with a gout attack, as well as medication and lifestyle changes to prevent further attacks. Pain relief for a gout attack What to do during an attack You should: take any medication you've been prescribed as early as possible after you notice an attack see below — this should start to have an effect within two or three days rest and raise the limb avoid knocking or damaging the affected joint keep the joint cool — remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel ensure you're well hydrated Apply the ice pack to your joint for around 20 minutes.

NSAIDs used to treat gout include naproxen, diclofenac and etoricoxib. Colchicine reduces some of the swelling and pain associated with a gout attack. Corticosteroids Corticosteroids are sometimes used to treat severe cases of gout if other treatments don't work or you're unable to take an NSAID or colchicine. A person can have elevated uric acid levels without any outward symptoms. While individuals do not need treatment at this stage, high uric acid levels in the blood can cause silent tissue damage.

As a result, a doctor may advise a person with high uric acid levels to address factors possibly contributing to its buildup. This stage occurs when urate crystals in a joint suddenly cause acute inflammation and intense pain.

Stressful live events and excessive alcohol consumption could be contributors to flare-ups. This stage is the period in between attacks of acute gout. Between these periods, urate crystals may continue to build up in tissue. Chronic tophaceous gout is the most debilitating type of gout and may result in permanent damage to the joints and the kidneys.

At this stage, people can have chronic arthritis and develop tophi in cooler areas of the body, such as the joints of the fingers. Chronic tophaceous gout typically occurs after many years of acute gout attacks. However, it is unlikely that individuals who receive proper treatment progress to this stage. One condition that experts easily confuse with gout is calcium pyrophosphate deposition, known as pseudogout.

The symptoms of pseudogout are very similar to those of gout, although the flare-ups are usually less severe. The major difference between gout and pseudogout is that the joints are irritated by calcium pyrophosphate crystals rather than urate crystals.

Pseudogout requires different treatments than gout. The body produces uric acid during the breakdown of purines. These are chemical compounds found in high amounts in certain foods such as meat, poultry, and seafood. Typically, uric acid is dissolved in the blood and excreted from the body in urine via the kidneys. If a person produces too much uric acid or does not excrete enough, it can build up and form needle-like crystals.

These trigger inflammation and pain in the joints and surrounding tissue. Clinical manifestations and diagnosis of gout. Gout or pseudogout adult. Mayo Clinic.

Gloperba prescribing information. Food and Drug Administration. Accessed Jan. Perez-Ruiz F. Pharmacologic urate-lowering therapy and treatment of topic in patients with gout.

FitzGerald JD, et al. Chang-Miller A expert opinion. Related Diuretics: Cause of gout? Glucosamine: Can it worsen gout symptoms? Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.