Gout treatment, diagnosis & prescriptions

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Consultations work similarly to in-person appointments — the doctor can complete an assessment by asking questions about your symptoms, going through your health history, and determining what treatment is right for you. If they think your condition is more serious, they may tell you to go to a clinic for an in-person examination.

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Yes, you can. A healthcare practitioner will want to discuss the symptoms and signs of gout that you’re experiencing, as well as your medical history.

In some cases, the healthcare provider may be able to provide a gout diagnosis based on the symptoms and appearance of the affected area. In others the healthcare practitioner may suggest additional testing to reinforce a gout diagnosis.

Once you have a gout diagnosis, the healthcare provider can suggest appropriate gout treatments based on the severity of the flare-up.

Gout is a common and complex form of arthritis that typically affects joints and soft tissues. Gout is caused by hyperuricemia (excess uric acid in the blood), and deposits of monosodium urate (MSU) crystals in soft tissues, tendons, bursae, and joints.

Most of the time, signs of gout first appear in the big toe (about 50% of initial cases), but gout symptoms can also affect:

• Fingers
• Toes
• Knees
• Midtarsal
• Wrists
• Elbows
• Ankles

This painful condition is becoming more prevalent each year, rising alongside the obesity epidemic that is affecting Canada and the United States.

The symptoms and signs of gout often appear suddenly, and more frequently at night.

The most common gout symptom is intense joint pain at the affected area. The pain is so intense that it wakes you up from just the soft weight of a bed sheet touching the joint. This most frequently occurs in the big toe but can affect other joints. Pain can linger in joints for days or weeks after the most severe symptoms fade.

Another frequently occurring sign of gout is inflammation and redness at the affected area, which may feel warm to the touch.

As it progresses, gout can cause you to lose some of the range of motion in your joints. This is because eventually gout can cause structural changes to joints and periarticular tissues, which can result in chronic gout symptoms.

Directly, gout is caused by a build-up of uric acid in the blood, and deposits of monosodium urate (MSU) crystals in soft tissues and joints. In some cases, it can also affect bursae (fluid-filled sacs surrounding joints), as well as tendons.

Your body produces uric acid and urate crystals by breaking down purines, which is a substance found in certain foods and drinks. It also occurs naturally in the body.

Certain environmental, medical, and lifestyle factors are known to cause gout flare-ups. Some of these include:

• Obesity
• Consuming too many purine-rich foods or drinks (organ meats, red meat, certain types of seafood, and non-diet sodas)
• Consuming excessive amounts of alcohol (particularly beer, gin, whisky, vodka, rum, and wine)
• Overeating, prolonged fasting, or dehydration
• Hypertension (high blood pressure)
• Diabetes or metabolic syndrome
• Heart diseases
• Kidney diseases
• Certain medications (low-dose aspirin, medications for treating hypertension)
• Family history of gout
• Age (men often develop gout between 30 and 50 while women generally develop gout after menopause)
• Recent physical trauma or surgery

A healthcare practitioner will most likely be able to provide a diagnosis for gout by evaluating your symptoms, medical history, and examining the affected area.

In some cases, the healthcare provider may suggest additional testing in order to confirm a gout diagnosis. This could include:

• X-ray imaging (to rule out other causes of inflammation)
• Joint fluid test
• Blood tests to check uric acid levels. This test may not be definitive as some people can have high levels of uric acid in their blood without experiencing gout symptoms
• Ultrasound
• Dual-energy computerized tomography (DECT)

Once the healthcare practitioner is able to provide a gout diagnosis, they can suggest appropriate gout treatments based on the severity of your symptoms.

Gout treatments are typically focused on two different areas. The first type focuses on controlling pain and inflammation. The second type of treatment is designed to help reduce uric acid levels in your blood, to reduce the chance of complications and minimize gout flare ups.

Some lifestyle changes will normally be recommended, especially if flare-ups may be related directly to your diet or weight. Limiting alcoholic beverages and avoiding high-purine foods will help reduce your body from producing excess uric acid.

Losing weight and exercising regularly can help your body more efficiently process uric acid, so that there’s less opportunity for urate crystals to form.

There are a number of prescription gout medications that can be suggested to treat gout attacks as well as prevent gout complications. Some of these include:

• Colchicine
• Nonsteroidal anti-inflammatory drugs (NSAID)
• Corticosteroids
• Medications that block uric acid production
• Medications that improve your kidneys’ ability to remove uric acid

If you’ve begun showing signs of gout, it’s a good idea to talk to a healthcare provider.

Without lifestyle changes and treatments, gout can be an extremely painful chronic condition. A healthcare practitioner can help identify gout, and suggest treatments that will help control your symptoms.

Gout symptoms can feel debilitating, but you don’t have to manage them alone. Through a combination of lifestyle adjustments and prescription gout medications, a healthcare provider from Maple can help manage symptoms, avoid complications, and minimize flare ups.