Causes, symptoms, treatment, and prevention of gout

Causes, symptoms, treatment, and prevention of gout



Gout is a condition that can suddenly assault your joints or soft tissues with excruciating pain, swelling, and redness. The big toe joints are frequently the site of the earliest episodes, although gout can affect many other joints as well. This form of inflammatory arthritis is the most prevalent. As you become older, your chances of developing it increase. It affects more men than women.

People who have high blood levels of uric acid, commonly known as urate, are more likely to develop gout. Every day, when our systems break down purines, ureate is produced. Purines are substances that our bodies naturally produce but which are also found in some meals.


It is natural and healthy for everyone to have urate in their blood. But if levels rise too high, gout may result.

In the past, people believed that binge eating and excessive alcohol consumption were the causes of gout. While this may increase the likelihood of gout attacks, it is not the complete picture.

On any given day, only roughly a quarter of the urate in our bodies comes from food and drink; the other three-quarters come from the body’s breakdown of purines.

Your body eliminates any excess urate as urate levels rise through your kidneys and through your wee.


However, levels start to rise if your body produces too much urate or if your kidneys are unable to excrete enough of it.


Urate crystals may progressively form if urate concentrations are too high.


They mainly develop in and around cartilage and other hard joint structures. However, crystals can also develop inside your body, including in your kidneys and under your skin.


What are the effects and symptoms?

Urate crystals can accumulate in your joints for years if you have gout without realizing it. Some crystals may leak out from the cartilage into the space between the two bones in a joint if there are many crystals present in the joint.


The synovium, the delicate lining of the joint, can become inflamed and swollen when the tiny, hard, sharp crystals brush against it. This is referred to as a gout attack or flare-up. A flare-up, also known as a flare, is a period of time during which a condition’s symptoms return or worsen.


Gout attacks cause the afflicted joint to become:


    Very Painful






As the attack subsides, the skin over the joint may start to peel off and appear shiny.Attacks frequently start out rapidly and happen at night.The fast onset of symptoms is referred to by doctors as “acute.” It can last longer, but the attack normally ends within five to seven days. Gout attacks may become more frequent and may extend to new joints if addressed.

Attacks frequently begin in the early morning hours and typically affect the joint near the base of the big toe. The signs appear suddenly. Typically, people have their worst symptoms within the first 12 to 24 hours of you becoming aware of a problem.


Any light pressure on the injured joint is excruciatingly painful; wearing socks or the weight of a bedsheet can be agonizing.

The big toe is the joint that gout most frequently affects, although other joints, such as the ankles, knees, elbows, wrists, and fingers, may also be affected.

It is possible for multiple joints to be impacted at once.

Gout is uncommon in joints towards the center of the body, such as the spine, shoulders, or hips.

Gout attacks are particularly prevalent in the joints at the tips of your arms and legs, including your fingers and toes.

This might be as a result of the colder temperatures in these bodily regions, which increase the likelihood of crystal formation.



In addition to accumulating outside of the joints, urate crystals can be seen under the skin and form tophi, which are tiny, solid lumps. The urate crystals’ white color can occasionally be seen under the skin.

Tophi Most Frequently Appear.

  • Over the top of the toes
  • Back of the heel
  • Front of the knee
  • Backs of the fingers and wrists
  • Around the elbow
  • The ears.



Although tophi often don’t hurt, they can interfere with daily tasks. These urate crystals occasionally get irritated, degrade, and release fluid containing grittier white substance.

Additionally, tophi can develop inside of your joints, harming your bone and cartilage.


What triggers gout?

There are two distinct varieties of gout. Primary gout refers to when you have it without a known underlying cause. It’s referred to as secondary gout when it’s brought on by another condition. There are two potential secondary gout causes:


Long-term medication use for chronic kidney disease can have an impact on how well your kidneys can remove urea from your body.


Common conditions that link with gout include: 

  • Chronic kidney disease
  • High cholesterol and fats in the blood 
  • High blood pressure 
  • Type 2 diabetes  
  • Osteoarthritis



What could start an attack?

The crystals may shake loose and enter your joint cavity for a number of reasons, leading to an attack. These include: a knock or injury to a joint; a fever-producing illness; getting surgery; eating an unusually large meal, especially one that is fatty; drinking too much alcohol; being dehydrated; starting urate lowering therapy (ULT), particularly at a high dose; or failing to take your ULT regularly each day.


How to manage on your own


Modifications in way of life. You can take steps to avoid gout attacks and further joint damage in addition to adhering to your doctor’s prescribed course of therapy.


  • To keep your weight at a healthy level, engage in regular exercise and dietary monitoring.
  • To help your body rid itself of uric acid, drink plenty of water.
  • Reduce your calorie consumption, especially fat-based calories.
  • Avoid sugary beverages.
  • Consume complex carbs.
  • Consume low-fat dairy products to get protein. High purine foods include meat and seafood. Some people’s uric acid levels may rise as a result of consuming too much of these.
  • Skip the alcohol




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A review article by

Dr Bhavana Kalvala

(Clinical Research Director @ IEEARC Tech)

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