Gout is usually caused by too much uric acid in the body (hyperuricemia). Excess uric acid in the body causes uric acid crystals (monosodium urate) to accumulate in the body’s joints, fluids, and tissues. Hyperuricemia does not always cause gout, and hyperuricemia without symptoms of gout does not require treatment.
Because gout is mainly caused by excess uric acid in the blood, foods that contain high levels of purines, compounds that can raise uric acid levels, should be limited or avoided.
Foods that may trigger gout attacks include:
- Alcoholic beverages (any kind)
- Seafood, including anchovies, sardines, herring, mussels, codfish, scallops, trout, haddock, mackerel, crab, shrimp, and others
- Some meats, such as turkey, chicken, duck, beef, veal, pork, bacon, ham, venison and organ meats like liver, kidney, and tripe
- Shellfish, such as crab, lobster, oysters, and shrimp
- Sodas with high-fructose corn syrup
Risk factors for developing gout include:
- Certain health conditions, including:
- Overeating or prolonged fasting
- A diet high in purines, which the body breaks down into uric acid
- Purine-rich foods include red meat, organ meat, and some seafood, such as sardines, anchovies, scallops, mussels, trout, and tuna
- Consuming large amounts of meat or seafood
- Consuming beverages containing high fructose corn syrup (such as regular sodas)
- Excessive and regular consumption of alcohol (especially beer, vodka, gin, whiskey, or rum)
- Certain medications that affect blood levels of urate, such as diuretics (water pills)
- Being male
What Are Symptoms of Gout?
Symptoms of gout can come on quickly, over a few hours, and can last about three to 10 days. When gout symptoms worsen it is called gout attack or flare, and remission is a period of no symptoms.
Symptoms of gout attacks (flares) include:
- Sudden episodes of severe joint pain
- Redness, swelling, heat, and tenderness of the joint is common
- Tends to affect a single joint, but inflammation can occur in several joints at the same time
- Commonly occurs in the big toe, and also in lesser toe joints, ankles, and knees
- Can also affect the fingers
- Onset of a flare happens more often during the night and early morning than during the day, though attacks can occur any time
- Pain and inflammation peak within 12 to 24 hours and usually subside completely within a few days to several weeks, even if not treated
- May be accompanied by fever
Flares are usually followed by periods of remission where patients have no symptoms that can last weeks, months, or years.
What Is the Treatment for Gout?
The goal of treatment for gout flares is to reduce pain and inflammation. Treatment is usually short-term and limited to the duration of the flare.
Anti-inflammatory medications used to treat gout flares include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Colchicine (Colcrys)
Patients who develop clumps of uric acid crystals around a joint (tophi) and kidney stones may be treated with medications including: