Gout is a form of arthritis that is usually caused by excessive uric acid in the blood. This is called hyperuricemia.

• Hyperuricemia can lead to uric acid crystals forming in a joint or joints.
• These uric acid cyrstals can lead to attacks of joint swelling, redness, heat and pain. The attacks frequently occur in the joint at the base of the big toe.
• Gout attacks can come on suddenly, frequently at night.
• Before age sixty, men develop gout more often than women. However, after age sixty, men and women are affected equally.
• Gout is extremely uncommon in children.

The exact cause of gout is not known. Most cases of gout are related to a decrease in the kidney's ability to get rid of the uric acid made by the body. Attacks of gout may be triggered by:

• Heavy alcohol use
• Excessive dietary intake of purines, including certain fish (i.e., herring, sardines, cod, haddock, salmon, trout, tuna and anchovies), alcohol (especially beer), caffeine, organ meats, fried foods and beef.
• Dehydration
• Fasting or extremely low-calorie diets
• Certain medications or cancer chemotherapy treatments

Gout usually affects one joint at a time, often the joint at the base of the big toe. Joints in the knees, ankles, feet, elbows or hands can also be affected. Acute gout attacks normally last about a week. During an acute attack, affected joints can become:

• Red
• Painful
• Swollen
• Warm
• Difficult to use.

Some people can also develop a moderate fever or the chills during an attack.

Sometimes gout attacks get better on their own. Unfortunately, more attacks typically follow within the next few months or years.

• Attacks may begin to occur more often and last longer.
• The attacks can result in significant joint damage.

Diagnosing gout early is important to:

• Delay and limit joint damage
• Pevent possible complications
• Limit pain, which can be severe

Contact your healthcare provider if you have any of the above symptoms. He or she will take a medical history and perform a physical exam. They may order lab tests and possibly remove fluid from an affected joint.

• A diagnosis can frequently be made by your healthcare provider after taking your medical history and examining you.
• The diagnosis can be confirmed by identifying uric acid crystals in fluid removed from the affected joint.
• Blood tests showing high uric acid levels do not always indicate gout. Many people with high uric acid levels never develop gout and there may be normal uric acid levels during a gout attack.
• An ultrasound, x-ray, CT scan or MRI may be helpful in determining the amount of joint damage caused by gout.

There is no cure for gout. The condition can usually be controlled through:

• Medication to help prevent future attacks
• Medication to relieve the pain and inflammation that occurs during an attack, such as certain anti-inflammatory medications
• Diet and lifestyle changes

Make sure you tell your provider if you have other health problems, such as cardiac disease or gastrointestinal problems.

Prevention of acute attacks is the focus of managing gout. The goals of treatment are to:

• Control uric acid levels
• Prevent future attacks and joint damage
• Treat sudden attacks

If you believe you may have gout, contact your healthcare provider. Be prepared to discuss your symptoms and how long you have had them.

• Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
• Make a list of your medications (including over-the-counter).
• Write down any questions, symptoms or concerns you want to talk about.
• If your healthcare provider prescribes a medication for you, ask for a generic version.
• If your healthcare provider thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

Here are some questions to ask your healthcare provider.

• What are some of the complications of gout? Am I at high risk for complications?
• What treatment, if any, are you recommending? What options are available?
• If medication is recommended, how long will I need to take it? What are the possible side effects?
• How long will it take my symptoms to improve?
• What are my follow-up plans and what symptoms should I report if I am concerned that my symptoms may be getting worse?
• What tests are you recommending? What is the reason for those tests? Will the test results change my treatment plan?

Source UHC.com

Also known as:

Toe Pain

Swollen Toe

Pain in Toe

Gout

Big Toe