If you’ve heard of gout, you’ve probably also heard a lot of myths about it. Maybe someone told you it only affects men, or that you can only get it if you eat too many steaks. If you’ve been diagnosed with gout, those messages can be confusing or frustrating.
Jessica Patel, MD, a rheumatologist with Northeast Medical Group at Yale New Haven Health, explains the facts about gout.
What is gout?
Gout is a type of arthritis that occurs when there is too much uric acid in your blood. When uric acid levels get too high, it can form tiny, sharp crystals that settle in the joints. Your immune system doesn’t like that —so it reacts with sudden, intense inflammation. This is what we call gout.
As a “crystalline arthritis,” gout is very different from osteoarthritis (a “wear-and-tear” type of arthritis) or autoimmune forms of the disease (such as rheumatoid or psoriatic arthritis).
What are the symptoms?
Many people describe gout flares as an “attack” because they are sudden and intense. Gout attacks often come with:
- Severe joint pain (often overnight)
- Redness and swelling
- Warmth and tenderness
After years of elevated uric acid and recurrent gout flares without appropriate treatment, gout may cause joint stiffness.
Which areas of the body are usually affected?
Although the big toe is a classic site, gout can also affect ankles, knees, wrists, fingers, and elbows.
Some people with untreated gout may develop tophi, which are deposits of uric acid crystals that appear like hard lumps around joints. Gout can also cause kidney stones, joint damage and chronic kidney disease. Chronically high levels of uric acid can also affect the cardiovascular system, which can lead to coronary artery disease, stroke, heart failure and high blood pressure.
What are the risk factors for gout?
If your diet includes lots of red meat, seafood, alcohol (especially beer) and sugary drinks, it can put you at risk for gout.
Gout is also fairly common in people with kidney disease, high blood pressure, diabetes and heart disease. Other risk factors include obesity, certain medications such as diuretics, a strong family history of gout, prior joint injuries or a recent surgery or illness.
Once I have gout, will it be a chronic condition?
Gout is a long-term condition. You can go months — or even years—between attacks. However, uric acid crystals can still build up, and you eventually have another episode. If gout is not controlled, the attacks will happen more frequently, last longer and start to affect more joints.
But it’s important to understand that it is very treatable. Think of gout like high blood pressure or diabetes. If you take the appropriate medications and make lifestyle changes, gout is manageable – and you can reduce or even prevent flareups.
How can I manage symptoms or prevent flareups?
Managing symptoms include staying on medications as prescribed by your doctor, making changes to your lifestyle, and also having a plan should a flare up start. Treating symptoms early will reduce the duration of gout flare and severity of pain.
Ice applied to the joint will also help reduce pain during acute gout flares. (Remember: ice, not heat!)
Changes to your diet can help prevent flares. Limit or avoid red meat/organ meat, shellfish and seafood, high sugar or sweetened drinks, and alcohol. Foods that help lower gout risk include vegetables and healthy fats such as nuts. Stay well hydrated. Some patients say that drinking tart-cherry juice also helps when they have flares.
When should I see a doctor?
Remember: Gout is caused by many factors, and not all are related to lifestyle or diet. You should see your doctor if you have an acute swollen toe or any other joint.
