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Understanding gout

Older man enjoying a salad.

Medication and lifestyle changes can help ease the pain of this type of arthritis. 

You don't have to be rich to develop gout. But eating foods that are rich in purines can increase your risk for the painful condition.

Once thought of as an exclusive disease of the rich—because it was incorrectly associated only with overindulging in expensive foods and beverages—gout can affect anyone.

But with proper treatment, you can control the symptoms of gout.

What is gout?

Gout is a painful form of arthritis that has been recognized since ancient times, according to the American College of Rheumatology.

The condition occurs when too much uric acid builds up in the body and needle-like crystals develop in the joints. In advanced gout, deposits of crystals—called tophi—can develop under the skin and appear as lumps.

Uric acid is normally dissolved in blood and passed through the kidneys into urine. But if your body produces too much uric acid or your kidneys are not able to remove enough of it from your body, you can develop gout, according to the National Institutes of Health (NIH).

Early symptoms of gout usually involve intense episodes of painful swelling in single joints—most commonly the big toe. But gout can also affect the ankles, heels, wrists, fingers and elbows.

In addition to swelling, other symptoms of gout include redness, heat, pain and stiffness. Initially, gout attacks usually occur at night.

Who is at risk for gout?

Millions of people in the United States will suffer from gout during their lifetimes. It usually develops in middle age, and men are at greater risk. Women usually don't develop gout before menopause.

According to the NIH and Arthritis Foundation, other gout risk factors include:

  • A family history of the disease.
  • Being overweight.
  • Drinking too much alcohol.
  • Eating too many foods rich in purines like meat and many kinds of seafood.
  • High blood pressure.
  • Diabetes.
  • High cholesterol and triglycerides.
  • Some medications, such as diuretics.

How is gout diagnosed?

Gout can be difficult to diagnose because the symptoms are not always clear and are often the same as symptoms of other types of arthritis. But gout is generally suspected if a person has swelling and intense pain in one or two joints followed by pain-free periods between attacks.

To check for gout, a doctor may insert a needle in an inflamed joint and draw fluid samples to test for uric acid crystals, according to the NIH.

How is gout treated?

With proper treatment, gout can usually be managed. But without treatment, gout can lead to serious joint problems and other health conditions, such as kidney stones.

Several different treatments are used to reduce pain and prevent further gout attacks. Taking prescription medications at the first sign of gout pain can often help relieve symptoms.

The NIH also offers these additional tips for treating gout:

  • Avoid foods high in purines. This includes red meat and organ meat; seafood like anchovies, tuna, mussels and sardines; gravy; and sugary drinks and foods high in fructose.
  • Do not drink alcohol in excess.
  • Maintain a healthy weight by exercising regularly and choosing a nutritious diet.
  • Drink plenty of nonalcoholic fluids, especially water.

It's also important to tell your doctor about any medications you are taking. He or she can tell you if they might increase your risk for gout.

By following your doctor's advice and taking some lifestyle precautions, you can prevent or manage gout and live a rich life.

Reviewed 7/3/2023

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