Gout is a type of arthritis that occurs in small joints of the body, most commonly the big toe, although it may occur in the feet, ankles, knees, hands, and wrists. The affected joint or joints become swollen, tender and red, and look and feel "hot". Movement is usually difficult.
The pain tends to come on suddenly and reaches a peak in four to 12 hours. Although the first episode usually resolves in a few days, future gout attacks are likely to last longer and affect more joints.
Gout was once thought of as a rich man's disease because it tended to only afflict those who had access to copious amounts of food and alcohol. But modern research shows gout has little to do with wealth. Doctors know that gout occurs when uric acid crystallizes in a joint. Uric acid is a waste product that is formed when purines - crucial substances found in protein and other foods - are broken down. Under normal conditions, uric acid dissolves in the blood, passes through the kidneys, and is excreted in the urine. Not so in people with gout.
But while people with high levels of uric acid in their body are more likely to get gout, the relationship between uric acid and gout is not clear-cut. Gout doesn't affect everybody who has high uric acid levels and sometimes gout attacks occur when levels are low. However, it is our immune system fighting the process of crystals of uric acid occurring in the joint that causes the swelling, redness and intense pain.
Risk Factors for Gout
Gout is more likely to occur in:
Men. Men have a seven to nine times higher risk of gout than women, although the risk increases for women after menopause
People with a diet high in purine-rich foods such as red meat, organ meats (such as kidneys, liver, or brains), seafood (for example, herring, mussels, or sardines). Processed foods (for example chips, frozen dinners), refined carbohydrates (such as white bread and white rice) and beverages high in fructose or sucrose also contribute to gout
Certain ethnicities (such as African Americans, Hmong Chinese, Pacific Islanders)
People who overindulge in alcohol, particularly beer and spirits
People with certain medical conditions (such as cancer and psoriasis), and with some medications (like aspirin or diuretics) or treatments (for example, chemotherapy or radiation).
Diagnosis of Gout
If you experience sudden, intense pain in a joint, see your doctor for a diagnosis. Gout that is not treated can cause irreversible joint damage, kidney stones and the formation of tophi.
Tophi are small, chalk-colored, stone-like deposits of uric acid that collect under the skin and are most frequently found in skin around the joints and on the outside of the ear.
Treatment of Gout
Gout treatment can be categorized into medicines used to treat an acute attack, and medicines used to prevent gout complications, such as tophi.
Medicines used to treat gout attacks relieve pain and inflammation and include:
Nonsteroidal anti-inflammatory drugs (NSAIDs)
colchicine
Corticosteroids.
Medicines to prevent recurrences of gout either block the production of uric acid or improve its removal. Examples include:
allopurinol
febuxostat
pegloticase
probenecid.
Ideally, doctors aim for a target uric acid level of less than 6.0mg/dL (360 µmol/L) for most people with hyperuricemia associated with gout.
Although medications are the most effective way to prevent and treat gout, a few lifestyle changes go a long way in reducing the risk of future attacks.
Avoid sweetened drinks containing fructose or sucrose, and alcoholic beverages such as beer and spirits. Drink plenty of water.
Limit your intake of purine-rich foods such as red meats, organ meats, and seafood. Eat mostly fresh vegetables and use low-fat dairy products as a protein source.
Exercise regularly and lose weight if you are overweight.
Drugs used to treat Gout
The medications listed below are related to or used in the treatment of this condition.
The following products are considered to be alternative treatments or natural remedies for Gout. Their efficacy
may not have been scientifically tested to the same degree as the drugs listed in the table above. However, there may be historical,
cultural or anecdotal evidence linking their use to the treatment of Gout.
For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).
Activity
Activity is based on recent site visitor activity relative to other medications in the list.
Rx
Prescription only.
OTC
Over-the-counter.
Rx/OTC
Prescription or Over-the-counter.
Off-label
This medication may not be approved by the FDA for the treatment of this condition.
EUA
An Emergency Use Authorization (EUA) allows the FDA to authorize unapproved medical products or unapproved uses of approved medical products to be used in a declared public health emergency when there are no adequate, approved, and available alternatives.
Expanded Access
Expanded Access is a potential pathway for a patient with a serious or immediately life-threatening disease or condition to gain access to an investigational medical product (drug, biologic, or medical device) for treatment outside of clinical trials when no comparable or satisfactory alternative therapy options are available.
Pregnancy Category
A
Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.
C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use in pregnant women despite potential risks.
X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use in pregnant women clearly outweigh potential benefits.
N
FDA has not classified the drug.
Controlled Substances Act (CSA) Schedule
M
The drug has multiple schedules. The schedule may depend on the exact dosage form or strength of the medication.
U
CSA Schedule is unknown.
N
Is not subject to the Controlled Substances Act.
1
Has a high potential for abuse. Has no currently accepted medical use in treatment in the United States. There is a lack of accepted safety for use under medical supervision.
2
Has a high potential for abuse. Has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions. Abuse may lead to severe psychological or physical dependence.
3
Has a potential for abuse less than those in schedules 1 and 2. Has a currently accepted medical use in treatment in the United States. Abuse may lead to moderate or low physical dependence or high psychological dependence.
4
Has a low potential for abuse relative to those in schedule 3. It has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 3.
5
Has a low potential for abuse relative to those in schedule 4. Has a currently accepted medical use in treatment in the United States. Abuse may lead to limited physical dependence or psychological dependence relative to those in schedule 4.
Alcohol
X
Interacts with Alcohol.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
