Causes and Risk Factors
Gout develops when the body makes too much uric acid or the kidneys remove too little of it. Several factors raise the risk:- Diet: Red meat, organ meats, and certain shellfish are rich in purines, which the body breaks down into uric acid. Beer, liquor, and drinks sweetened with high-fructose corn syrup also raise uric acid levels.
- Medical conditions: High blood pressure, obesity, kidney disease, and diabetes are all associated with gout.
- Medications: Diuretics ("water pills") and low-dose aspirin can reduce how much uric acid the kidneys clear.
- Family history: Gout often runs in families, and genes influence how the body handles uric acid.
- Other triggers: Dehydration, fasting, recent surgery, and serious illness can set off a flare in someone prone to gout - and in St. Petersburg's year-round heat, staying well hydrated is an easy first defense.
- Age and sex: Men develop gout earlier, typically between 30 and 50; women are usually affected after menopause.
Symptoms
Gout attacks, called flares, often begin at night and reach peak intensity within hours. Between flares, most people feel entirely normal, which makes it tempting to put off long-term treatment. Typical features include:- Sudden, severe joint pain: The big toe is the classic site, but gout can strike the ankles, knees, elbows, wrists, and fingers.
- Swelling, redness, and warmth: The joint may look shiny and feel so tender that even the weight of a bedsheet hurts.
- Lingering discomfort: After the worst pain eases, soreness can last from a few days to a few weeks.
- Limited motion: As gout progresses, affected joints may become stiff and harder to move.
Diagnosis
Your physician will review your symptoms and may confirm the diagnosis with testing:- Joint fluid analysis: Fluid drawn from the joint is examined under a microscope for urate crystals - the most definitive test.
- Blood tests: A uric acid level supports the diagnosis, although the level can be misleadingly normal during a flare.
- Imaging: Ultrasound or X-rays help detect crystal deposits and rule out other problems, such as osteoarthritis or a joint infection.
Treatment
Treatment has two goals: calming the flare and lowering uric acid long term.- Flare relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen, the anti-inflammatory medicine colchicine, and corticosteroids such as prednisone can shorten an attack, especially when started early.
- Urate-lowering therapy: For repeated flares, tophi, or kidney involvement, daily medication such as allopurinol lowers uric acid and helps prevent future attacks. It is continued long term, even when you feel well.
- Lifestyle measures: Staying well hydrated, limiting alcohol and sugary drinks, moderating purine-rich foods, and gradual weight loss all reduce flare frequency.