Q&A: Gout

What is gout?

An inflammation caused by a build-up of uric acid in the blood. Uric acid forms crystals in a joint; that cause it to suddenly become violently inflamed. This often happens at night, when the joint becomes very painful and stiff. It is red, warm and swollen. It often involves the joint between the big toe and the metatarsus and sometimes a joint in the midfoot, ankle, knee or wrist.

Who can get it?

People with too much uric acid in the blood: 10 percent of them will have a gout attack at some point. People with kidney disease and leukemia patients are more likely to get gout, as are people who drink alcohol excessively or take certain medications, such as water pills.

How often does it occur?

With age, the risk of getting gout increases. Men are affected four times more often than women. Ultimately, more than 4 percent of men older than 75 years suffer from gout. A gout attack usually goes away within one to three weeks. It comes back to almost everyone. Within a year, 70 percent will have a second attack. Only 7 percent have not had a second attack after ten years.

What can you do against an attack?

The doctor can give a painkiller (diclofenac, naproxen or ibuprofen), which quickly reduces the pain. If that doesn’t help, you may be given the drug colchicine. In the first days of a gout attack, rest and cooling of the joint helps. Later, moving is actually good.

What can you do yourself to prevent gout?

If you’ve never had it, there are no meaningful measures to prevent it. People who have already had an attack can sometimes do something about it themselves. Excessive users of alcohol can drink less, users of water pills can switch to a different type of water pill. It is recommended to use at least two liters of fluid per day. A new gout attack may be prevented by eating less purine foods (chicken or game). Purine increases the uric acid level in the blood.

And if it comes back often?

If the gout attacks three or more times a year, the doctor will investigate whether this is because too much uric acid is being produced (which is the case in about 20 percent of patients) or because too little uric acid is removed from the body by the kidneys (80 percent). In the first case, allopurinol (Allopurinol, Apurin, Zyloric) is the drug of choice. In the second case, it can be benzbromarone (Desuric).

How bad can it get?

The gout crystals can form kidney stones. Most people today can live normal lives with medication, but gout can eventually deform joints, making movement painful. Gout has been said to increase the risk of cardiovascular disease, but it turns out that’s not the case.

Does the weather affect it?

Certain weather changes, such as when rain is on the way, can worsen pain and stiffness in some people with gout. But the weather probably has no influence on the development or course of gout.