Gaining an Understanding of Gout
Published: 10 March 2020
Published: 10 March 2020
Gout affects nearly 1% of Australians with severe episodes of pain and swelling that can often occur without any warning.
Gout is a common type of inflammatory arthritis that causes sudden flares of pain, swelling and redness in the joints. Symptoms have a much quicker onset than other forms of arthritis, and attacks often occur overnight (Better Health Channel 2018).
Gout generally affects joints in the limbs - usually one at a time - such as feet, ankles, knees, elbows, wrists, fingers and toes (especially the big toe) (Arthritis Australia 2017).
Gout is caused by an excess of uric acid; a byproduct that is normally excreted through urine. When there is excess uric acid in the blood, either because the kidneys can not excrete it quickly enough or too much has been produced, it forms crystals (‘urate’) in the joints. These crystals cause painful inflammations (Harvard Health Publishing 2019; Healthdirect 2018).
Hyperuricaemia is the term used to describe high levels of uric acid in the blood. This condition alone is not necessarily a prerequisite to gout and can be present without symptoms, suggesting that gout is instead the result of a combination of factors (Better Health Channel 2018).
The following risk factors apply for a person being diagnosed with gout:
(Better Health Channel 2018)
According to self-reported data, 187,000 or 0.8 per cent of Australians have gout. 87% of these people are male (AIHW 2019).
(Musculoskeletal Australia n.d.; Healthdirect 2018)
Gout attacks usually last for around a week (untreated) and symptoms may then disappear for long periods of time (possibly months or years). However, if gout is not managed properly, flares may become more severe and frequent, leading to permanent damage.
If repeated attacks occur, it may become a chronic condition (Arthritis Australia 2017; AIHW 2019).
Chronic gout symptoms may include:
(Arthritis Australia 2017)
A combination of medical tests may be conducted to determine if someone has gout, but the most definitive method of diagnosis is to take a sample of fluid from the joint and look for uric acid crystals under a microscope (Better Health Channel 2018).
A blood test can measure urate levels in the body but does not necessarily indicate gout (Better Health Channel 2018). Urate levels may even be normal or lower than usual during an attack (Arthritis Australia 2017).
The first step to treating gout is generally to manage the attack by alleviating any pain and inflammation. This may involve medication and rest (Musculoskeletal Australia n.d.).
If you are experiencing recurring attacks, medication may be prescribed to lower the level of uric acid in your blood (Healthdirect 2018). You may also be encouraged to make lifestyle changes such as reducing alcohol intake, losing weight and maintaining a balanced diet (Healthdirect 2018).
You may be able to prevent future attacks through self-management including:
(Musculoskeletal Australia n.d.)
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