Question: What is (are) Gout ?
Answer: Sudden, Intense Joint Pain Gout is a form of arthritis that causes the sudden onset of intense pain and swelling in the joints, which also may be warm and red. Attacks frequently occur at night and can be triggered by stressful events, alcohol or drugs, or the presence of another illness. Early attacks usually subside within 3 to 10 days, even without treatment, and the next attack may not occur for months or even years. Where Gout Usually Occurs Sometime during the course of the disease, many patients will develop gout in the big toe. Gout frequently affects joints in the lower part of the body such as the ankles, heels, knees, or toes. Who is at Risk? Adult men, particularly those between the ages of 40 and 50, are more likely to develop gout than women, who rarely develop the disease before menstruation ends. A Buildup of Uric Acid Before an attack, needle-like crystals of uric acid build up in connective tissue, in the joint space between two bones, or in both. Uric acid is a substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods. Normally, uric acid is dissolved in the blood and passed through the kidneys into the urine, where it is eliminated. If there is an increase in the production of uric acid or if the kidneys do not eliminate enough uric acid from the body, levels of it build up in the blood (a condition called hyperuricemia). Hyperuricemia also may result when a person eats too many high-purine foods, such as liver, dried beans and peas, anchovies, and gravies. Hyperuricemia is not a disease, and by itself it is not dangerous. However, if too many uric acid crystals form as a result of hyperuricemia, gout can develop. The crystals form and build up in the joint, causing inflammation. Stages of Gout Gout can progress through four stages. Asymptomatic (without symptoms) hyperuricemia. In this stage, a person has elevated levels of uric acid in the blood (hyperuricemia), but no other symptoms. Treatment is usually not required. Acute gout, or acute gouty arthritis. In this stage, hyperuricemia has caused uric acid crystals to build up in joint spaces. This leads to a sudden onset of intense pain and swelling in the joints, which also may be warm and very tender. An acute (sudden) attack commonly occurs at night and can be triggered by stressful events, alcohol or drugs, or the presence of another illness. Attacks usually subside within 3 to 10 days, even without treatment, and the next attack may not occur for months or even years. Over time, however, attacks can last longer and occur more frequently. Interval or intercritical gout. This is the period between acute attacks. In this stage, a person does not have any symptoms. Chronic tophaceous (toe FAY shus) gout. This is the most disabling stage of gout. It usually develops over a long period, such as 10 years. In this stage, the disease may have caused permanent damage to the affected joints and sometimes to the kidneys. With proper treatment, most people with gout do not progress to this advanced stage.
Source: NIHSeniorHealth

Question: What causes Gout ?
Answer: A Buildup of Uric Acid Most people with gout have too much uric acid in their blood, a condition called hyperuricemia. Uric acid is a substance that results from the breakdown of purines which are a part of all human tissue and found in many foods. Needle-like crystals of uric acid can build up in the connective tissue, in the joint space between two bones, or both. If too many uric acid crystals form as a result of hyperuricemia, gout can develop. Risk Factors These risk factors are associated with gout. - Genetics. Many people with gout have a family history of the disease. Genetics. Many people with gout have a family history of the disease. - Gender and age. Gout is more common in men than in women and more common in adults than in children. Gender and age. Gout is more common in men than in women and more common in adults than in children. - Weight. Being overweight increases the risk of developing gout because there is more tissue available for turnover or breakdown, which leads to excess uric acid production. Weight. Being overweight increases the risk of developing gout because there is more tissue available for turnover or breakdown, which leads to excess uric acid production. - Alcohol consumption. Drinking too much alcohol can lead to a buildup of uric acid because alcohol interferes with the removal of uric acid from the body. Alcohol consumption. Drinking too much alcohol can lead to a buildup of uric acid because alcohol interferes with the removal of uric acid from the body. - Diet. Eating too many foods that are rich in purines such as liver, dried beans and peas, anchovies and gravies, can cause or aggravate gout in some people. Diet. Eating too many foods that are rich in purines such as liver, dried beans and peas, anchovies and gravies, can cause or aggravate gout in some people. - Lead exposure. In some cases, exposure to lead in the environment can cause gout. Lead exposure. In some cases, exposure to lead in the environment can cause gout. - Other health problems. Renal insufficiency, or the inability of the kidneys to eliminate waste products, is a common cause of gout in older people. Other medical problems that contribute to high blood levels of uric acid include - high blood pressure - hypothyroidism (underactive thyroid gland) - conditions that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic anemia, or some cancers - Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps control uric acid levels either is not present or is found in insufficient quantities. Other health problems. Renal insufficiency, or the inability of the kidneys to eliminate waste products, is a common cause of gout in older people. Other medical problems that contribute to high blood levels of uric acid include - high blood pressure - hypothyroidism (underactive thyroid gland) - conditions that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic anemia, or some cancers - Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps control uric acid levels either is not present or is found in insufficient quantities. - high blood pressure - hypothyroidism (underactive thyroid gland) - conditions that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic anemia, or some cancers - Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps control uric acid levels either is not present or is found in insufficient quantities. high blood pressure hypothyroidism (underactive thyroid gland) conditions that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic anemia, or some cancers Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps control uric acid levels either is not present or is found in insufficient quantities. - Medications. A number of medications may put people at risk for developing hyperuricemia and gout. They include - diuretics, which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine - salicylate-containing drugs, such as aspirin - niacin, a vitamin also known as nicotinic acid - cyclosporine, a medication that suppresses the bodys immune system (the system that protects the body from infection and disease). This medication is used in the treatment of some autoimmune diseases and to prevent the bodys rejection of transplanted organs. - levodopa, a medicine used in the treatment of Parkinsons disease. Medications. A number of medications may put people at risk for developing hyperuricemia and gout. They include - diuretics, which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine - salicylate-containing drugs, such as aspirin - niacin, a vitamin also known as nicotinic acid - cyclosporine, a medication that suppresses the bodys immune system (the system that protects the body from infection and disease). This medication is used in the treatment of some autoimmune diseases and to prevent the bodys rejection of transplanted organs. - levodopa, a medicine used in the treatment of Parkinsons disease. - diuretics, which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine - salicylate-containing drugs, such as aspirin - niacin, a vitamin also known as nicotinic acid - cyclosporine, a medication that suppresses the bodys immune system (the system that protects the body from infection and disease). This medication is used in the treatment of some autoimmune diseases and to prevent the bodys rejection of transplanted organs. - levodopa, a medicine used in the treatment of Parkinsons disease. diuretics, which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine salicylate-containing drugs, such as aspirin niacin, a vitamin also known as nicotinic acid cyclosporine, a medication that suppresses the bodys immune system (the system that protects the body from infection and disease). This medication is used in the treatment of some autoimmune diseases and to prevent the bodys rejection of transplanted organs. levodopa, a medicine used in the treatment of Parkinsons disease.
Source: NIHSeniorHealth

Question: What are the symptoms of Gout ?
Answer: Attacks Usually Start at Night Gout is a form of arthritis that causes sudden onset of intense pain and swelling in the joints, which also may be warm and red. Gout typically attacks one joint at a time, and the attacks usually begin at night. Where Gout Usually Occurs Gout normally attacks joints in the lower part of the body, such as the knee, ankle or big toe. For many people, the joints in the big toe are the first to be attacked. In fact, sometime during the course of the disease, many people will develop gout in the big toe. Other Signs and Symptoms These can include - hyperuricemia -- high levels of uric acid in the body hyperuricemia -- high levels of uric acid in the body - the presence of uric acid crystals in joint fluid the presence of uric acid crystals in joint fluid - more than one attack of acute arthritis more than one attack of acute arthritis - arthritis that develops in a day, producing a swollen, red, and warm joint arthritis that develops in a day, producing a swollen, red, and warm joint - an attack of arthritis in only one joint, often the toe, ankle, or knee. an attack of arthritis in only one joint, often the toe, ankle, or knee. Diagnosis May Be Difficult Gout may be difficult for doctors to diagnose because the symptoms can be vague, and gout often mimics other conditions. Although most people with gout have hyperuricemia at some time during the course of their disease, it may not be present during an acute attack. In addition, having hyperuricemia alone does not mean that a person will get gout. In fact, most people with hyperuricemia do not develop the disease. Testing for Gout To confirm a diagnosis of gout, the doctor inserts a needle into the inflamed joint and draws a sample of synovial fluid, the substance that lubricates a joint. A laboratory technician places some of the fluid on a slide and looks for monosodium urate crystals under a microscope. If crystals are found in the joint fluid, the person usually has gout.
Source: NIHSeniorHealth

Question: What are the treatments for Gout ?
Answer: Symptoms Can Be Controlled With proper treatment, most people with gout are able to control their symptoms and live productive lives. The goals for treatment are to ease the pain that comes from sudden attacks, prevent future attacks, stop uric acid buildup in the tissues and joint space between two bones, and prevent kidney stones from forming. Common Treatments The most common treatments for an attack of gout are high doses of non-steroidal anti-inflammatory drugs (NSAIDs) which are taken by mouth, or corticosteroids, which are taken by mouth or injected into the affected joint. Patients often begin to improve within a few hours of treatment. The attack usually goes away completely within a week or so. Several NSAIDs are available over the counter. It is important to check with your doctor concerning the safety of using these drugs and to verify the proper dosage. When NSAIDs or corticosteroids fail to control pain and swelling, the doctor may use another drug, colchicine. This drug is most effective when taken within the first 12 hours of an acute attack. For patients who have repeated gout attacks, the doctor may prescribe medicine such as allupurinol, febuxostat, or probenecid to lower uric acid levels. In severe cases of gout that do not respond to other treatments, pegloticase, a medicine administered by intravenous infusion, may be prescribed to reduce levels of uric acid.
Source: NIHSeniorHealth

Question: what research (or clinical trials) is being done for Gout ?
Answer: Because uric acids role in gout is well understood and medications to ease attacks and reduce the risk or severity of future attacks are widely available, gout is one of the mostif not the mostcontrollable forms of arthritis. But researchers continue to make advances that help people live with gout. Perhaps someday these advances will prevent this extremely painful disease. Here are some areas of gout research. - Refining current treatments. Although many medications are available to treat gout, doctors are trying to determine which of the treatments are most effective and at which dosages. Recent studies have compared the effectiveness of different NSAIDs in treating the pain and inflammation of gout and have looked at the optimal dosages of other treatments to control and/or prevent painful attacks. Refining current treatments. Although many medications are available to treat gout, doctors are trying to determine which of the treatments are most effective and at which dosages. Recent studies have compared the effectiveness of different NSAIDs in treating the pain and inflammation of gout and have looked at the optimal dosages of other treatments to control and/or prevent painful attacks. - Evaluating new therapies. A number of new therapies have shown promise in recent studies including biologic agents that block a chemical called tumor necrosis factor. This chemical is believed to play a role in the inflammation of gout. Evaluating new therapies. A number of new therapies have shown promise in recent studies including biologic agents that block a chemical called tumor necrosis factor. This chemical is believed to play a role in the inflammation of gout. - Discovering the role of foods. Gout is the one form of arthritis for which there is proof that specific foods worsen the symptoms. Now, research is suggesting that certain foods may also prevent gout. In one study scientists found that a high intake of low-fat dairy products reduces the risk of gout in men by half. The reason for this protective effect is not yet known. Another study examining the effects of vitamin C on uric acid suggests that it may be beneficial in the prevention and management of gout and other diseases that are associated with uric acid production. Discovering the role of foods. Gout is the one form of arthritis for which there is proof that specific foods worsen the symptoms. Now, research is suggesting that certain foods may also prevent gout. In one study scientists found that a high intake of low-fat dairy products reduces the risk of gout in men by half. The reason for this protective effect is not yet known. Another study examining the effects of vitamin C on uric acid suggests that it may be beneficial in the prevention and management of gout and other diseases that are associated with uric acid production. - Searching for new treatment approaches. Scientists are also studying the contributions of different types of cells that participate in both the acute and chronic joint manifestations of gout. The specific goals of this research are to better understand how urate crystals activate white blood cells called neutrophils, leading to acute gout attacks; how urate crystals affect the immune system, leading to chronic gout; and how urate crystals interact with bone cells in a way that causes debilitating bone lesions among people with chronic gout. The hope is that a better understanding of the various inflammatory reactions that occur in gout will provide innovative clues for treatment. Searching for new treatment approaches. Scientists are also studying the contributions of different types of cells that participate in both the acute and chronic joint manifestations of gout. The specific goals of this research are to better understand how urate crystals activate white blood cells called neutrophils, leading to acute gout attacks; how urate crystals affect the immune system, leading to chronic gout; and how urate crystals interact with bone cells in a way that causes debilitating bone lesions among people with chronic gout. The hope is that a better understanding of the various inflammatory reactions that occur in gout will provide innovative clues for treatment. - Examining how genetics and environmental factors can affect hyperuricemia. Researchers are studying different populations in which gout is prevalent to determine how certain genes and environmental factors may affect blood levels of uric acid, which can leak out and crystallize in the joint, leading to gout. Examining how genetics and environmental factors can affect hyperuricemia. Researchers are studying different populations in which gout is prevalent to determine how certain genes and environmental factors may affect blood levels of uric acid, which can leak out and crystallize in the joint, leading to gout.
Source: NIHSeniorHealth

Question: What is (are) Gout ?
Answer: Gout is a form of arthritis that causes sudden onset of intense pain and swelling in the joints, which also may be warm and red. Attacks frequently occur at night and can be triggered by stressful events, alcohol or drugs, or the presence of another illness. Sometime during the course of the disease, many people will develop gout in the big toe. Gout frequently affects joints in the lower part of the body such as the knees, ankles, or toes.
Source: NIHSeniorHealth

Question: Who is at risk for Gout? ?
Answer: Renal insufficiency, or the inability of the kidneys to eliminate waste products, is a common cause of gout in older people. Here are other medical problems that contribute to high blood levels of uric acid and can put people at risk for gout. - high blood pressure - hypothyroidism (underactive thyroid gland) - conditions that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic anemia, or some cancers - Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps control uric acid levels either is not present or is found in insufficient quantities. high blood pressure hypothyroidism (underactive thyroid gland) conditions that cause an excessively rapid turnover of cells, such as psoriasis, hemolytic anemia, or some cancers Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome, two rare conditions in which the enzyme that helps control uric acid levels either is not present or is found in insufficient quantities.
Source: NIHSeniorHealth

Question: Who is at risk for Gout? ?
Answer: Yes. A number of medications may put people at risk for developing hyperuricemia and gout. They include - diuretics, which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine. (High levels of uric acid in the blood can lead to gout.) - salicylate-containing drugs, such as aspirin - niacin, a vitamin also known as nicotinic acid - cyclosporine, a medication that suppresses the bodys immune system (the system that protects the body from infection and disease). This medication is used in the treatment of some autoimmune diseases and to prevent the bodys rejection of transplanted organs. - levodopa, a medicine used in the treatment of Parkinsons disease. diuretics, which are taken to eliminate excess fluid from the body in conditions like hypertension, edema, and heart disease, and which decrease the amount of uric acid passed in the urine. (High levels of uric acid in the blood can lead to gout.) salicylate-containing drugs, such as aspirin niacin, a vitamin also known as nicotinic acid cyclosporine, a medication that suppresses the bodys immune system (the system that protects the body from infection and disease). This medication is used in the treatment of some autoimmune diseases and to prevent the bodys rejection of transplanted organs. levodopa, a medicine used in the treatment of Parkinsons disease.
Source: NIHSeniorHealth

Question: What are the symptoms of Gout ?
Answer: Gout is a form of arthritis that frequently affects joints in the lower part of the body such as the knees, ankles, or toes. The affected joint may become swollen, red, or warm. Attacks usually occur at night. Sometime during the course of the disease, many patients will develop gout in the big toe. Other signs and symptoms of gout include - hyperuricemia -- high levels of uric acid in the body - the presence of uric acid crystals in joint fluid - more than one attack of acute arthritis - arthritis that develops in a day, producing a swollen, red, and warm joint - attack of arthritis in only one joint, often the toe, ankle, or knee. hyperuricemia -- high levels of uric acid in the body the presence of uric acid crystals in joint fluid more than one attack of acute arthritis arthritis that develops in a day, producing a swollen, red, and warm joint attack of arthritis in only one joint, often the toe, ankle, or knee.
Source: NIHSeniorHealth

Question: How to diagnose Gout ?
Answer: To confirm a diagnosis of gout, the doctor inserts a needle into the inflamed joint and draws a sample of synovial fluid, the substance that lubricates a joint. A laboratory technician places some of the fluid on a slide and looks for uric acid crystals under a microscope. If uric acid crystals are found in the fluid surrounding the joint, the person usually has gout.
Source: NIHSeniorHealth

Question: What are the treatments for Gout ?
Answer: Physicians often prescribe high doses of non-steroidal anti-inflammatory drugs (NSAIDs) or steroids for a sudden attack of gout. NSAIDs are taken by mouth and corticosteroids are either taken by mouth or injected into the affected joint. Patients often begin to improve within a few hours of treatment, and the attack usually goes away completely within a week or so. When NSAIDs or corticosteroids fail to control pain and swelling, the doctor may use another drug, colchicine. This drug is most effective when taken within the first 12 hours of an acute attack. For patients who have repeated gout attacks, the doctor may prescribe medicine such as allupurinol, febuxostat, or probenecid to lower uric acid levels. In severe cases of gout that do not respond to other treatments, pegloticase, a medicine administered by intravenous infusion, may be prescribed to reduce levels of uric acid.
Source: NIHSeniorHealth

Question: What is (are) Gout ?
Answer: The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) at NIH has more information about gout. Check out the information here. Also, see "Key Words" related to gout.
Source: NIHSeniorHealth