Chronic Gout

A good time to deal with and treat (with a goal to cure) your chronic gout pain is to start working on it today so learn about Chronic Gout now - pills for gout Gout is a type of arthritis. It occurs when uric acid builds up in blood and causes inflammation in the joints. Chronic refers to something that continues over an extended period of time. A chronic condition is usually long-lasting and does not easily or quickly go away - like gout.

Acute gout is a painful condition that often affects only one joint.
Chronic gout is repeated episodes of pain and inflammation. More than one joint may be affected.

Causes of Gout

Gout is caused by having higher-than-normal levels of uric acid in your body. This may occur if:

Your body makes too much uric acid
Your body has a hard time getting rid of uric acid

If too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell and become inflamed.

The exact cause is unknown. Gout may run in families. The problem is more common in men, in women after menopause, and people who drink alcohol.

The condition may also develop in people with:

Diabetes
Kidney disease
Obesity
Sickle cell anemia and other anemias
Leukemia and other blood cancers

Gout may occur after taking medicines that interfere with the removal of uric acid from the body. People who take certain medicines, such as hydrochlorothiazide and other water pills, may have higher levels of uric acid in the blood.

Symptoms of Gout

Symptoms of acute gout:

Only one or a few joints are affected. The big toe, knee, or ankle joints are most often affected.
The pain starts suddenly, often during the night. Pain is often described as throbbing, crushing, or excruciating.
The joint appears warm and red. It is usually very tender and swollen (it hurts to put a sheet or blanket over it).
There may be a fever.
The attack may go away in a few days, but may return from time to time. Additional attacks often last longer.

People will have no symptoms after a first gout attack. Many people will have another attack in the next 6-12 months.

Some people may develop chronic gout. This is also called gouty arthritis. This condition can lead to joint damage and loss of motion in the joints. People with chronic gout will have joint pain and other symptoms most of the time.

Tophi are lumps below the skin around joints or other places such as the finger tips and ears. Tophi can develop after a person has had gout for many years. These lumps may drain chalky material.

Exams and Tests for Gout

Tests that may be done include:

Synovial fluid analysis (shows uric acid crystals)
Uric acid - blood
Joint x-rays (may be normal)
Synovial biopsy
Uric acid - urine

Not everyone with high uric acid levels in the blood has gout. A level over 7 mg/dL is high.

Treatment for Gout

Take medicines for gout as soon as you can if you have a sudden attack.

Take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or indomethacin when symptoms begin. Talk to your health care provider about the correct dose. You will need stronger doses for a few days.

Your health care provider may prescribe strong painkillers such as codeine, hydrocodone, and oxycodone.
A prescription medicine called colchicine helps reduce pain, swelling, and inflammation.
Corticosteroids (such as prednisone) can also be very effective. Your doctor may inject the inflamed joint with steroids to relieve the pain.
The pain often goes away within 12-hours of starting treatment. Most of the time all pain is gone within 48-hours.

Your doctor may prescribe medicines you take daily (such as allopurinol or probenecid) to decrease uric acid levels in your blood. You may need these medicines if:

You have several attacks during the same year or your attacks are quite severe.
You have damage to joints.
You have tophi.
You have kidney disease or uric acid kidney stones.

Diet and lifestyle changes may help prevent gouty attacks:

Decrease alcohol, especially beer (some wine may be helpful).
Lose weight.
Exercise daily.
Limit your intake of red meat and sugary beverages.
Choose healthy foods such as dairy products, vegetables, nuts, legumes, fruits (less sugary ones), and whole grains.
Drink coffee and take vitamin C supplements (may help some people).

Outlook / Prognosis for Gout

Proper treatment of acute attacks allows people to live a normal life. However, the acute form of the disease may progress to chronic gout.

Possible Complications of Gout

Chronic gouty arthritis
Kidney stones
Deposits in the kidneys, leading to chronic kidney failure

When to Contact a Medical Professional

Call your health care provider if you have symptoms of acute gouty arthritis.

Prevention of Gout

You may not be able to prevent gout but may be able to avoid things that trigger symptoms.

Alternative Names for Gout

Gouty arthritis - acute; Gout - acute; Hyperuricemia; Tophaceous gout; Tophi; Podagra; Gout - chronic; Chronic gout; Acute gout; Acute gouty arthritis

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