Gout: What You Should Know
By Alan S. Peterson, M.D.

What is gout?

Gout develops when you have too much uric acid in your body. Uric acid can build up and form crystals. The crystals can cause kidney stones, joint pain called gouty arthritis, or deposits under the skin called tophi (TOE-feye). Sometimes these deposits look like white pinpoint areas under the skin usually near a joint. These are actual crystals of the uric acid under the skin.

Who gets gout?

Usually men older than 30 years of age are most likely to get gout. Women can get it, but usually not until after menopause. Many times there is a family history, thus a genetic component is sometimes prevalent.

You are more likely to get gout if you are overweight, drink alcohol, or take diuretics (water pills) for high blood pressure or for leg swelling (edema). You are also more likely to get it if you are taking certain medicines after having received an organ transplant. Those who have gout have a greater chance of heart disease. Make sure your cholesterol is checked.

What is a gout (or gouty) attack?

A gout or gouty attack is when you have sudden pain, redness, and swelling in a joint. It usually happens at the base of the big toe, but it can happen in other joints. The pain can make even light touch to the joint seem unbearable. Those interested in the history of medicine will note pictures of Kings with large toe gout (podagra) lying in bed with their leg elevated and the bed “cradles” to keep sheets from touching their toes.

How will my doctor know if I have gout?

Your doctor may suspect gout because of your symptoms. An examination may include a blood sample and possibly fluid from the joint. If you have recurrent attacks it may be that no further tests are needed. There is no amount that is diagnostic of gout with elevation of uric acid in your blood to make the diagnosis, however. The higher the level the more likely it is statistically.

How is gout treated?

Medicine can help stop the pain and irritation in the joint during a gout attack. If you keep having attacks, your doctor may give you medicine to lower the level of uric acid in your body. You should keep taking the medicine even if you have another attack.

Staying at a healthy weight or losing excess weight can lower your risk of having another attack. If your doctor says it’s OK, when your attack subsides, walk for 20-30 minutes a day for exercise. You should not drink alcohol or eat a lot of red meat or organ meats (pancreas, liver or kidney meats).

Keeping your leg elevated above the level of your heart can decrease the pain when you have an acute lower extremity attack. If the attack is in your upper extremity, keeping it propped up above the level of your heart is also important.

Where can I get more information?