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Am Fam Physician. 1999;59(7):1810

See related article on gout.

What is gout?

Gout is a kind of arthritis caused by too much uric acid in the joints. The acid causes joint pain.

Who can get gout?

If you eat a lot of foods that are rich in purines, you may get gout. Some of these foods are salmon, sardines, liver and herring.

You may get gout if you're overweight, drink alcohol or have high cholesterol. Men have gout more often than women.

Some medicines may cause gout, such as certain diuretics (“water pills”), niacin (a B-complex vitamin), aspirin (taken in low doses), cyclosporine and some drugs used to treat cancer.

What is a gout attack like?

It may be sudden. It usually starts at night, often in the big toe. The joint becomes red, feels hot and hurts. The joint hurts more when you touch it. Other joints may also be affected.

What should I do if I have a gout attack?

The sooner you get treatment, the sooner the pain will go away. Your doctor can prescribe medicine to stop the joint swelling and pain.

You should rest in bed. Putting a hot pad or an ice pack on the joint may ease the pain. Keeping the weight of clothes or bed covers off the joint can also help.

With treatment, your gout attack should go away in a few days. You may never have another attack.

What if I don't get treatment?

If you don't get treatment, a gout attack can last for days or even weeks. If you keep having more attacks, more joints will be affected, and the attacks will last longer.

If you have gout attacks for many years, you may develop tophi (say: toe-fee). These are soft tissue swellings caused by uric acid crystals. Tophi usually form on the toes, fingers, hands and elbows. You may also get kidney disease or kidney stones. Over time, the bone around a joint may be destroyed.

What can I do to avoid gout attacks?

Your doctor can prescribe medicines to prevent future gout attacks. These medicines wash the uric acid from your joints, reduce the swelling or keep uric acid from forming.

You should lose weight if you need to. If you have high blood pressure or high cholesterol, get treatment and follow a low-salt, low-fat diet.

Stay away from alcohol and foods that are high in purines.

Drinking lots of water can help flush uric acid from your body.

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