What is gout?
Gout can be a very painful form of arthritis that is caused by deposits of urate crystals in your joints (distinct from the calcium crystal deposits of pseudogout). Attacks of gout normally come on very quickly. Certain things can make attacks more likely, such as drinking excess alcohol.
Urate crystals cause joint inflammation, which means the affected joint becomes painful, hot, swollen and red. Attacks typically affect the big toe, but can also affect ankles, knees, elbows, wrists and fingers.
When urate crystals collect outside the joint, they can sometimes be seen under the skin – these are called “tophi” and look like firm white lumps. These are not usually painful, but can sometimes cause the skin to break down.
If untreated, attacks of gout may get more frequent, and may start to involve more joints in the body.
How is gout treated?
The two main goals of treating gout are: treating the symptoms of an acute attack, and ongoing treatment to reduce the level of urate in the blood to prevent crystals from forming
Acute attacks are normally treated with either anti-inflammatories (NSAIDs) like ibuprofen, or colchicine – a drug which specifically reduces inflammation causes by crystal deposits. Steroids can also be helpful at reducing symptoms, either as an oral course, or by injection of the steroid directly into the affected joint.
For ongoing treatment to reduce urate in the blood stream, allopurinol is most often used. Your doctor will usually measure the level of urate in the blood before starting allopurinol, then reassess the level after a period of treatment, and adjust the dose if necessary.
A healthy lifestyle can also help in the treatment of gout, such as losing weight if you are obese, eating a “low purine” diet (see link below for more information), avoiding excess alcohol and avoid dehydration.
Where can I find out more about gout?
Arthritis Research UK
- Gout Information – including more information about the condition, how it is diagnosed and treated, and living with the condition
UK Gout Society
- Gout Diet Leaflet [PDF] – including more information about low purine foods