Symptoms
Gout attacks usually occur suddenly, and involve severe joint pain, swelling, and redness. After a few days, the joint returns to normal, but sometimes, if left untreated, the attack can last for weeks. A gout attack often happens at night. It can be triggered by several factors:
- Surgery
- Drinking large amounts of alcohol
- Eating large amounts of protein-rich foods
- Mild trauma to the foot
For many people, the first attack affects the big toe. In this condition, called podagra, your toe becomes hot, red, and swollen. You may suddenly wake up feeling excruciating pain just from the weight of the blanket touching it. The skin over the affected joint becomes tight, red, or purple-colored and shiny. The pain can last up to 10 days. Over the next week or two, discomfort decreases until the joint becomes normal again.
In an acute attack, you may also have chills, fever, a fast heartbeat, and generally feel sick all over.
If you do not receive treatment, attacks can happen more often and last longer, until the condition becomes chronic. If allowed to progress, gout may affect more joints, and over time, permanent joint damage may occur. In the fourth (chronic) stage of gout, the affected joints may become deformed, and their motion may become restricted. Tophi can develop in the kidneys and other organs, as well as around the elbow and under the skin of the ears. If tophi are not treated, they may open and release chalky chunks of crystals through the skin.
Risk Factors
Gout most often affects men between 40 and 50 years of age. About 275 of every 100,000 people develop gout. Men are more likely than women to have the disorder, and for them it develops at an earlier age. Women usually do not experience gout until after menopause. Young adults and children rarely get it; however, it is usually more severe in people who develop it before age 30.
Certain behaviors and conditions can increase the risk for excess uric acid in the blood and for gout [
Table 1 ]. You have a higher risk for gout if you have excess uric acid in your blood. However, not everyone with a high uric acid level develops gout. Risk factors include behaviors, medical conditions, and medications that decrease the body’s ability to eliminate uric acid.
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