Gout, inflammatory arthritis is a condition caused by monosodium urate (MSU) crystals in high quantities in the blood. A uric acid lab result of > 6.8 mg/dL may lead to gout symptoms.

Mitigating and resolving various factors, such as: obesity, high blood pressure, high cholesterol, diabetes, chronic kidney disease, unhealthy diet (limiting purine and fructose intake), and alcohol intake can significantly reduce the incidence of gout. 

Common Symptoms 

• very painful, swollen and red joints, often the big toes, ankles, feet, knees, fingers, hands, wrists or elbows 
• lack of preceding joint injury
• absence of fever

Possible Chronic Symptoms 

• recurring bouts of gout
• chronic inflammation in the same joint(s) or recurring in the same joint(s)
• lumps or bumps under the skin near joints called tophi or uric acid crystal deposits (Tophaceous gout)
• kidney stones related to uric acid deposits
• impaired or reduced kidney function

Risk Factors

• alcohol abuse
• certain medications
• obesity
• hypertension
• hyperlipidemia
• diabetes
• kidney disease

Treatment 

First line treatment is always modification of lifestyle and prevention. In the case of gout, these measures are nearly entirely diet related. The body makes uric acid from breaking down ingested purines. Hence a gout diet low in purines can help to reduce the uric acid levels in the blood. 

It is also necessary to go over your daily and occasional medications with your doctor as several medications can provoke a gout flare as well. 

Things to Avoid

• alcohol, specifically grain liquors like whiskey and vodka, and beer
• High-fructose items, especially sodas, ice cream, candy, fast foods, juices
• red meats, lamb and pork
• organ meats, for example, kidneys or liver
• seafood, explicitly shellfish (lobster, shrimp, sardines, mussel, anchovies)
• certain medications

Fortunately there are multiple effective treatment strategies to mitigate and decrease the burden of gout. Several medications are effective in stopping a gout flare in as little as a few days, talk with your provider about which one is best and safest for you. Discussing your heart and kidney health with your doctor is vital in determining the best treatment strategy for gout.

For individuals who suffer recurrent gout flares, daily prophylactic medications may be necessary. 

Not only are gout flares painful and capable of impairing the use of your hands, fingers or feet for daily activities or work, but unmanaged gout can cause underlying irreversible joint destruction (erosion of bone and cartilage).