Gout

Topic Overview

What is gout?

Gout is a kind of arthritis. It can cause an attack of sudden burning pain, stiffness, and swelling in a joint, usually a big toe. These attacks can happen over and over unless gout is treated. Over time, they can harm your joints, tendons, and other tissues. Gout is most common in men.

What causes gout?

Gout is caused by too much uric acid in the blood. Most of the time, having too much uric acid is not harmful. Many people with high levels in their blood never get gout. But when uric acid levels in the blood are too high, the uric acid may form hard crystals in your joints.

Your chances of getting gout are higher if you are overweight, drink too much alcohol, or eat too much meat and fish that are high in chemicals called purines. Some medicines, such as water pills (diuretics), can also bring on gout.

What are the symptoms?

The most common sign of gout is a nighttime attack of swelling, tenderness, redness, and sharp pain in your big toe. You can also get gout attacks in your foot, ankle, or knees. The attacks can last a few days or many weeks before the pain goes away. Another attack may not happen for months or years.

See your doctor even if your pain from gout is gone. The buildup of uric acid that led to your gout attack can still harm your joints.

How is gout diagnosed?

Your doctor will ask questions about your symptoms and do a physical exam. Your doctor may also take a sample of fluid from your joint to look for uric acid crystals. This is the best way to test for gout. Your doctor may also do a blood test to measure the amount of uric acid in your blood.

How is it treated?

To stop a gout attack, your doctor can give you a shot of corticosteroids, or prescribe a large daily dose of one or more medicines. The doses will get smaller as your symptoms go away. Relief from a gout attack often begins within 24 hours if you start treatment right away.

To ease the pain during a gout attack, rest the joint that hurts. Taking ibuprofen or another anti-inflammatory medicine can also help you feel better. But don't take aspirin. It can make gout worse by raising the uric acid level in the blood.

To prevent future attacks, your doctor can prescribe a medicine to reduce uric acid buildup in your blood. If your doctor prescribes medicine to lower your uric acid levels, be sure to take it as directed. Most people continue to take this medicine for the rest of their lives.

Paying attention to what you eat may help you manage your gout. Eat moderate amounts of a healthy mix of foods to control your weight and get the nutrients you need. Avoid regular daily intake of meat, seafood, and alcohol (especially beer). Drink plenty of water and other fluids.

Frequently Asked Questions

Learning about gout:

Being diagnosed:

Getting treatment:

Ongoing concerns:

Living with gout:

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  Gout: Changing your diet

Cause

Gout is caused by too much uric acid in the blood (hyperuricemia). Hyperuricemia usually does no harm, and many people with high levels of uric acid in the blood never develop gout. The exact cause of hyperuricemia sometimes is not discovered, although inherited factors (genes) seem to play a role. When uric acid levels in the blood are too high, uric acid may form crystals that build up in the joints. Gout can seem to flare up without specific cause or can be brought on by factors such as:

  • Certain conditions related to diet and body weight, such as:
    • Obesity.
    • Moderate to heavy alcohol ingestion, particularly beer.1
    • A diet rich in meat and seafood (high-purine foods).
    • Very low-calorie diets.
  • Medicines that may increase uric acid concentration, such as:
    • Regular use of aspirin or niacin.
    • Medicines that reduce the amount of salt and water in the body (diuretics).
    • Medicines that cause rapid cell death (chemotherapy, usually used to treat cancer).
    • Medicines that suppress the immune system, such as cyclosporine, that are used to prevent your body from rejecting an organ transplant.
  • Major illness or certain medical conditions, such as:
  • Surgery.
  • Having been born with a rare condition that causes high blood uric acid levels. People with Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome have a partial or complete deficiency in an enzyme that helps to control uric acid levels.

Symptoms

Gout usually develops after a number of years of buildup of uric acid crystals in the joints and surrounding tissues. Symptoms include:

  • Warmth, pain, swelling, and extreme tenderness in a joint, usually a big toe joint. This symptom is called podagra.
  • Pain that starts during the night and is so intense that even light pressure from a sheet is intolerable.
  • Rapid increase in discomfort, lasting for some hours of the night and then easing during the next few days.
  • As the gout attack subsides, the skin around the affected joint may peel and feel itchy.

Other symptoms may include:

  • Very red or purplish skin around the affected joint, which may appear to be infected.
  • Fever .
  • Limited movement in the affected joint.

Symptoms of gout vary.

  • Symptoms may occur after an illness or surgery.
  • Some people may not experience gout as many painful attacks but rather develop chronic gout. Chronic gout in older adults may be less painful and can be confused with other forms of arthritis.
  • Gout may first appear as nodules (tophi) on the hands, elbows, or ears. There may be no classic symptoms of a gout attack.

By the time you experience the symptoms of a gout attack, uric acid has been building up in your blood, and uric acid deposits have been forming on one or more of your joints.

The big toe joint is most commonly affected. But the joints of the feet, ankles, knees, wrists, fingers, and elbows may also be involved. Inflammation of the fluid sacs (bursae) that cushion tissues may develop, particularly in the elbow (olecranon bursitis) and knee (prepatellar bursitis).

There are many other conditions with symptoms similar to gout.

What Happens

Gout usually develops after a number of years of buildup of uric acid crystals in the joints and surrounding tissues. A gout attack usually starts during the night with moderate pain that grows worse. A gout attack typically causes pain, swelling, redness, and warmth (inflammation) in a single joint, most often the big toe (this symptom is called podagra), followed by the eventual disappearance of all symptoms.

  • Mild attacks may stop after several hours or last for 1 to 2 days. These attacks are often misdiagnosed as "tendinitis" or "sprain" even though there was no trauma or overuse.
  • Severe attacks may last up to several weeks, with soreness lasting for up to 1 month.
  • Most people have a second attack of gout within 6 months to 2 years after their first attack but there may be intervals of many years between attacks. If untreated, the frequency of attacks usually increases with time.

There are four stages of gout.2

First stage: High blood uric levels

  • The uric acid level in the blood may be higher than normal, but there are no symptoms of gout.
  • High uric acid in the blood (hyperuricemia) may never progress beyond this stage, and symptoms of gout may never develop.
  • Some people may have kidney stones before having their first attack of gout.

Second stage: Acute gout arthritis

  • Uric acid crystals begin to form in the joint fluid, usually in one joint—most commonly the big toe—and the body often responds with a sudden inflammatory reaction: a gout attack.
  • Although the big toe is the most common site for a gout attack, gout may develop in other joints, including the knee, ankle, and joints in the foot, wrist, and fingers.
  • After the gout attack is over, the affected joint and surrounding tissues feel normal within days until the next attack, which often occurs within 2 years.

Third stage: Interval gout

  • If you have previously had an attack of gout, you will very likely have another.
  • In this type of gout, you have no symptoms for a period of time between acute attacks.
  • In many people this period becomes progressively shorter as attacks occur more often. Later attacks may be more severe, last longer, and involve more than one joint.

Fourth stage: Chronic tophaceous gout

  • If gout symptoms have occurred off and on without treatment for several years, they may become ongoing (chronic) and frequently affect more than one joint. There may no longer be periods of time between attacks. This stage of gout is frequently confused with other forms of arthritis, most commonly osteoarthritis.
  • By this time, enough uric acid crystals have accumulated in the body to form gritty nodules called tophi. When located just under the surface of the skin, these deposits are usually firm and movable. The overlying skin may be thin and red. Tophi that are very near the skin may appear cream-colored or yellow.
  • At first, tophi are usually found on or near the elbow, over the fingers and toes, or on the outer edge of the ear.
  • If the condition progresses without treatment, tophi may form in the cartilage of the external ear or the tissues around the joint (bursae, ligaments, and tendons), resulting in pain, swelling, redness, and warmth (inflammation). Progressive crippling and destruction of cartilage and bone is possible.
  • This stage of gout is uncommon because of advances in the early treatment of gout.

What Increases Your Risk

Gout is caused by too much uric acid in the blood (hyperuricemia). The following risk factors can either cause hyperuricemia or make joints more susceptible to the formation of uric acid crystals:

  • Being male
  • Family history of gout
  • Obesity
  • Moderate, regular, or heavy consumption of alcohol, especially beer
  • A diet rich in meat and seafood, which can be high in purines
  • Use of medicines that remove salt and water from the body (diuretics)
  • Regular use of aspirin (more than 1 or 2 aspirin tablets a day)
  • Frequent episodes of dehydration
  • Acute illness or infection
  • Lead exposure (may occur through work, diet, or hobbies)
  • Very low-calorie diets
  • Injury to a joint

Gout and other conditions

Certain other conditions and diseases appear more often in people who have gout than in people who don't, though studies have not shown a clear relationship. It is thought that gout shares risk factors (such as obesity, hypertension, and high levels of triglycerides) with certain diseases, including:

When To Call a Doctor

Call or see your doctor immediately if you have:

  • Severe pain in a single joint that comes on very quickly.
  • Swollen, tender joints with overlying warm, reddened skin.

Watchful Waiting

During an acute gout attack, you may be able to relieve some of your discomfort by taking nonsteroidal anti-inflammatory drugs (NSAIDs) or colchicine and resting the affected joint until the attack eases. You can use ice to reduce the swelling.

Although aspirin is an NSAID, don't take it for gout. Aspirin can actually make gout worse by abruptly changing the uric acid level in the blood.

It is important that you see your doctor even if the pain from gout has disappeared. The uric acid buildup that caused your gout attack may still be irritating your joints and could eventually cause serious damage. Your doctor can prescribe medicines that will prevent and even reverse the uric acid buildup.

Who To See

The following health professionals can diagnose and prescribe treatment for gout:

To prepare for your appointment, see the topic Making the Most of Your Appointment.

Exams and Tests

The only certain way to diagnose gout is to have a joint fluid aspiration (arthrocentesis) test to see whether uric acid crystals are present. But for people with an acutely swollen, red, painful big toe, where it is often difficult to obtain joint fluid, a diagnosis can be made by the presence of a high blood uric acid level.

The following examinations and tests may help with diagnosis and treatment of gout:

While X-rays of extremities (hands and feet) are sometimes useful in the late stages of the disease, X-rays are not usually helpful in the early diagnosis of gout. When gout is in a late stage, nodules (tophi) or even “punched-out” (worn away or eroded) areas of bone near joints may be seen. The pain of gout often causes people to seek medical attention before any long-term changes can be seen on an X-ray. But X-rays may help to rule out other causes of arthritis. See an X-ray of gout in the foot.

Treatment Overview

The goals of treatment for gout are rapid pain relief and prevention of future gout attacks and long-term complications, such as joint destruction and kidney damage. Treatment includes medicines and steps you can take at home to prevent future attacks.

Initial treatment

Gout is treated with medicines to relieve symptoms and measures to eliminate causes. Specific treatment depends on whether you are having an acute attack or are trying to prevent future attacks.

To reduce the pain, swelling, redness, and warmth of the affected joint(s) in an acute gout attack:

To prevent recurrent attacks:

  • Take a medicine that reduces uric acid levels in the blood, which reduces the risk of future attacks.
  • Take steps to reduce the risk of future attacks.
    • Control your weight. Being overweight is a risk factor for gout. If you are overweight, a diet that is low in fat may help you lose weight. But very low-calorie diets increase the amount of uric acid produced by the body and may bring on a gout attack. For more information, see the topic Weight Management.
    • Limit alcohol, especially beer. Alcohol can reduce the release of uric acid by the kidneys into your urine, causing an increase of uric acid in your body. Beer, which is rich in purines, appears to be worse than some other beverages that contain alcohol.1
    • Limit meat and seafood. Diets high in meat and seafood (high-purine foods) can raise uric acid levels.
    • Talk to your doctor about the medicines you take. Certain medicines that are given for other conditions reduce the amount of uric acid eliminated by the kidneys. These include pills that reduce the amount of salt and water in the body (diuretics, or "water pills") and niacin. Regular use of low-dose aspirin may raise the uric acid level. Since low-dose aspirin may be important for the prevention of stroke or heart attack, your doctor may want you to continue to take low-dose aspirin.
    • Follow a moderate exercise program.

If your doctor prescribes medicine to lower your uric acid levels, be sure to take it as directed. Most people continue to take this medicine for the rest of their lives.

If the blood uric acid is high but a person has never had an attack of gout, treatment is rarely needed. But people with extremely elevated levels may need regular testing for signs of kidney damage, and they may need long-term treatment to lower their uric acid levels. Your blood uric acid level may be watched by your doctor until it is lowered to normal levels.

Ongoing treatment

If you have previously had a gout attack, you are likely to have another, especially if you are not managing the disease with medicines or other treatment. The goal of treatment is to prevent future attacks, to reduce high levels of uric acid (hyperuricemia), and to identify and treat the causes of your hyperuricemia. Your doctor will review your health history and current health status to identify other medical conditions and medicines that could be causing the elevated uric acid levels. Factors such as alcohol consumption, diet, and body weight can be modified to lower your uric acid levels and reduce the risk of future gout attacks.

To reduce the pain, swelling, redness, and warmth of the affected joint(s) in an acute gout attack:

To prevent recurrent attacks:

  • Take a medicine that reduces uric acid levels in the blood, which reduces the risk of future attacks.
    • Uricosuric agents increase elimination of uric acid by the kidneys.
    • Drugs such as allopurinol decrease production of uric acid by the body.
    • Colchicine is often prescribed to prevent flare-ups during the first months that you are taking uric acid-lowering medicines.
  • Take steps to reduce the risk of future attacks.
    • Control your weight. Being overweight is a risk factor for gout. If you are overweight, a diet that is low in fat may help you lose weight. But very low-calorie diets increase the amount of uric acid produced by the body and may bring on a gout attack. For more information, see the topic Weight Management.
    • Limit alcohol, especially beer. Alcohol can reduce the release of uric acid by the kidneys into your urine, causing an increase of uric acid in your body. Beer, which is rich in purines, appears to be worse than some other beverages that contain alcohol.1
    • Limit meat and seafood. Diets high in meat and seafood (high-purine foods) can raise uric acid levels.
    • Making changes in your diet may help with your gout. If you want to try an eating plan for gout, see:
      Click here to view an Actionset.Gout: Changing your diet.
    • Talk to your doctor about the medicines you take. Certain medicines that are given for other conditions reduce the amount of uric acid eliminated by the kidneys. These include pills that reduce the amount of salt and water in the body (diuretics, or "water pills") and niacin. Regular use of low-dose aspirin may raise the uric acid level. Since low-dose aspirin may be important for the prevention of stroke or heart attack, your doctor may want you to continue to take low-dose aspirin.
    • Follow a moderate exercise program.

Long-term medication treatment depends on how high your uric acid levels are and how likely it is that you will have other gout attacks in the future. If your doctor prescribes medicine to lower your uric acid levels, be sure to take it as directed. Most people continue to take this medicine for the rest of their lives.

Treatment if the condition gets worse

Gout can usually be successfully treated by eliminating its causes and taking medicines to relieve symptoms. But if gout symptoms have occurred off and on without treatment for several years, they may become ongoing (chronic) and may affect more than one joint. Uric acid crystals may have built up in the joints to form gritty, chalklike nodules called tophi. Treatment of gout that has advanced to this stage includes medicines.

  • Take one or more of the following medicines, as prescribed by your doctor:
  • If you are having pain in the joints from an attack, your doctor may prescribe:
    • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or indomethacin. Avoid aspirin, which may abruptly raise uric acid levels in the blood.
    • Colchicine.
    • Oral corticosteroids, such as prednisone or medrol.
    • A shot of corticosteroids in a muscle.
    • A shot of corticosteroids directly into the painful joint.
  • To prevent recurrent attacks, you may be prescribed:
    • Uricosuric agents to increase elimination of uric acid by the kidneys.
    • Drugs such as allopurinol to decrease production of uric acid by the body.
    • Colchicine to prevent flare-ups during the first months that you are taking uric acid-lowering medicines.

Treatment to eliminate tophi may include:3

  • Allopurinol medication, which may shrink the tophi until they disappear.
  • In rare cases, surgery to remove large tophi that are causing deformity.

What To Think About

After an acute attack of gout, talk with your doctor about the causes of the elevated uric acid levels in your blood. A review of your overall health may reveal diseases, medicines, and habits that could be contributing to your uric acid levels.

Most doctors will wait several days to weeks after a gout attack is over to begin medicine to lower the high uric acid levels. These medicines can cause uric acid stored elsewhere in the body to begin moving through the bloodstream and could make symptoms worse if treatment begins during a gout attack.

If there is swelling that causes pressure in a large joint such as a knee or ankle, your doctor may relieve the pain and pressure by aspiration, in which a needle is inserted into the joint and fluid is drawn out (aspirated) with a syringe connected to the needle.4

Prevention

Gout usually develops after a number of years of buildup of uric acid crystals in the joints and surrounding tissue. You probably won't know that you have an elevated uric acid level in your blood until you have had your first gout attack. But you can help prevent or reduce the severity of future gout attacks.

  • If you have been prescribed medicines for gout, it is important that you take those medicines as instructed to prevent future attacks. Most people continue to take this medicine for the rest of their lives.
  • If you are overweight, take steps to lose weight. For more information, see the topic Weight Management.
  • You probably will be advised to reduce or stop your alcohol intake or to adjust your diet.
  • Making changes in your diet may help with your gout. If you want to try an eating plan for gout, see:
    Click here to view an Actionset.Gout: Changing your diet.

Home Treatment

Gout , an inflammatory joint disease causing acute pain and swelling, usually develops after a number of years of buildup of uric acid crystals in the joints and surrounding tissue. If you have been diagnosed with gout, take steps to:

  • Decrease the pain of an acute attack.
    • Rest the affected joint until the attack eases and for 24 hours after the attack.
    • Elevate painful joints.
    • Relieve inflammation by taking nonsteroidal anti-inflammatory drugs (NSAIDs). Do not take aspirin, which may abruptly change uric acid levels and may make symptoms worse.
  • Prevent recurrences.
    • Control your weight. Being overweight is a risk factor for gout. If you are overweight, a diet that is low in fat may help you lose weight. But avoid fasting or very low-calorie diets. Very low-calorie diets increase the amount of uric acid produced by the body and may bring on a gout attack. For more information, see the topic Weight Management.
    • Limit alcohol, especially beer. Alcohol can reduce the release of uric acid by the kidneys into your urine, causing an increase of uric acid in your body. Beer, which is rich in purines, appears to be worse than some other beverages that contain alcohol.1
    • Limit meat and seafood. Diets high in meat and seafood (high-purine foods) can raise uric acid levels.
    • Talk to your doctor about medicines you take. Certain medicines that are given for other conditions reduce the amount of uric acid eliminated by the kidneys. These include pills that reduce the amount of salt and water in the body (diuretics, or "water pills") and niacin. Regular use of low-dose aspirin may raise the uric acid level. Since low-dose aspirin may be important for the prevention of stroke or heart attack, your doctor may want you to continue to take low-dose aspirin.
  • Modify your risk factors.
    • Keep your weight within the normal range for your height.
    • Follow a moderate exercise program.
    • Avoid a diet rich in meat and seafood. Making changes in your diet may help with your gout. If you want to try an eating plan for gout, see:
      Click here to view an Actionset.Gout: Changing your diet.
    • Have an evaluation for lead poisoning if you have been exposed to lead in your job or through hobbies.
  • Continue to take the medicines prescribed to you for gout. But if you have not been taking medicines that lower uric acid (such as probenecid or allopurinol) prior to the attack, do not begin taking it when the attack begins. These medicines will not help relieve acute pain and may actually make it worse.

In the past, gout was thought to be due to drinking too much alcohol and eating too many rich foods. Although eating certain foods and drinking alcohol may trigger a rise in the level of uric acid in the body, these habits may not by themselves cause gout. Gout is most often caused by an overproduction of uric acid (due to metabolism problems) or decreased elimination of uric acid by the kidneys.

Medications

Medication treatment for gout may be done in two separate stages.

  • First, the pain, swelling, redness, and warmth (inflammation) during an attack of gout is treated until the symptoms have gone away.
  • Second, after the inflammation has subsided, other medicines may be used to reduce the uric acid level in the blood and reduce the frequency of future attacks. Most doctors do not start these medicines until several days to weeks after a gout attack is over.

Medicines to lower uric acid levels are not given until a gout attack is over. Starting these medicines during a gout attack can cause movement of uric acid stored elsewhere in the body, which can make the gout attack worse.

Long-term medication treatment depends on how high your uric acid levels are and how likely other gout attacks are. In general, the higher the uric acid levels and the more frequent the attacks, the more likely it is that long-term medication treatment will help.

During a gout attack

You may already be taking a medicine to lower uric acid levels in the blood at the time of an attack. If so, you should continue taking your medicine, even during an attack.

If you have been prescribed a medicine to lower uric acid levels (probenecid or allopurinol) and have not been taking the medicine, it is more likely that another gout attack will occur. Do not start taking the medicine during an attack. Medicines that control the uric acid levels in your blood can also make the uric acids stored elsewhere in the body move into your bloodstream. Starting these medicines while you are having a gout attack can make your attack much worse.

Medication Choices

Medication treatment for gout usually involves some combination of:

  • Short-term treatment, using medicines that relieve pain and reduce inflammation during an acute attack or prevent a recurrence of an acute attack. These medicines may include:
    • Nonsteroidal anti-inflammatory drugs (NSAIDs), except for aspirin, which should never be used to relieve pain during a gout attack. Aspirin may change uric acid levels in the blood and may make the attack worse.5
    • Colchicine, which may also be used for long-term treatment.
    • Corticosteroids, which may be given in pills or by a shot for cases of gout that do not respond to NSAIDs or colchicines. They may also be given to people who cannot take NSAIDs for other reasons, such as those with chronic kidney failure, heart failure, gastrointestinal bleeding or those using a blood-thinner, such as warfarin.
  • Long-term treatment, using medicines to lower uric acid levels in the blood, which can reduce the frequency and severity of gout attacks in the future. This may include:
    • Uricosuric agents, to increase elimination of uric acid by the kidneys.
    • Allopurinol or a newer medicine called febuxostat, to decrease production of uric acid by the body.
    • Colchicine, to prevent flare-ups during the first months that you are taking uric acid-lowering medicines.

What To Think About

  • Relief from symptoms in a gout attack often occurs within 24 hours if treatment is started immediately.
  • During a gout attack, your doctor will prescribe a maximum daily dose of one or more medicines used for short-term treatment to stop the attack. Doses are then reduced as the symptoms go away.
  • NSAIDs other than aspirin are used most often to treat a gout attack.
  • Because all medicines that lower uric acid levels in the blood have risks, an accurate diagnosis of gout is necessary before they are used.
  • Aspirin should never be used to relieve pain during a gout attack.

Some people with gout have continuing problems because they do not take their prescribed medicine. Although most people will need treatment for the rest of their lives to keep their uric acid levels in their blood normal, they may feel perfectly healthy most of the time and wonder why they should continue taking their medicine. If you stop taking your prescribed medicine, nothing may happen at first, but after a while another gout attack is likely to occur. Without treatment, future attacks are likely to be more severe and occur more often.

Research is ongoing to develop new medicines to treat the symptoms of gout. Scientists also are studying which medicines lower uric acid levels safely.6

  • Losartan is used to treat high blood pressure (hypertension), and it also lowers uric acid levels.
  • Fenofibrate is used to control certain fats in the blood (triglycerides and very low-density lipoprotein cholesterol), and it may also increase elimination of uric acid by the kidneys.
  • Urate oxidase may lower uric acid levels by changing uric acid into an absorbable molecule. This medicine is currently being evaluated in the United States.
  • Y-700 medicines decrease the amount of uric acid the body makes. These medicines are being studied and may be used in people who cannot take allopurinol.

Surgery

Gout can usually be successfully treated by eliminating causes and taking medicines to relieve symptoms. But if gout symptoms have occurred off and on without treatment for more than 10 years, uric acid crystals may have built up in the joints to form gritty, chalklike nodules called tophi. If tophi are causing infection, pain, pressure, and deformed joints, and medicines have been unsuccessful in shrinking or eliminating the tophi, your doctor may recommend surgery (excision) to remove them.

Other Treatment

Although not proved in scientific studies, complementary therapies may be used by some people to relieve symptoms caused by gout.7

  • Cherries and an herb called devil's claw are folk medicine remedies that have been used as anti-inflammatories to treat gout. Research is needed to evaluate the usefulness of these and other complementary medicines to treat gout.
  • Eicosapentaenoic acid (EPA) is known to reduce chronic inflammation. It has not yet been studied to see whether it can help reduce inflammation from gout.
  • Although still just a theory, some studies indicate that folic acid may be helpful in inhibiting the enzyme needed to produce uric acid.

Be sure to talk with your doctor if you are considering taking vitamins, minerals, or other remedies to help reduce future gout attacks.

Other Places To Get Help

Organizations

American College of Rheumatology
1800 Century Place
Suite 250
Atlanta, GA  30345
Phone: (404) 633-3777
Fax: (404) 633-1870
Web Address: www.rheumatology.org
 

The American College of Rheumatology (ACR) and the Association of Rheumatology Health Professionals (ARHP, a division of ACR) are professional organizations of rheumatologists and associated health professionals who are dedicated to healing, preventing disability from, and curing the many types of arthritis and related disabling and sometimes fatal disorders of the joints, muscles, and bones. Members of the ACR are physicians; members of the ARHP include research scientists, nurses, physical and occupational therapists, psychologists, and social workers. Both the ACR and the ARHP provide professional education for their members.

The ACR Web site offers patient information fact sheets about rheumatic diseases, about medicines used to treat rheumatic diseases, and about care professionals.


Arthritis Foundation
1330 West Peachtree Street
Suite 100
Atlanta, GA  30309
Phone: 1-800-283-7800
Web Address: www.arthritis.org
 

The Arthritis Foundation provides grants to help find a cure, prevention methods, and better treatment options for arthritis. It also provides a large number of community-based services nationwide to make living with arthritis easier, including self-help courses; water- and land-based exercise classes; support groups; home study groups; instructional videotapes; public forums; free educational brochures and booklets; the national, bimonthly consumer magazine Arthritis Today; and continuing education courses and publications for health professionals.


National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health
1 AMS Circle
Bethesda, MD  20892-3675
Phone: 1-877-22-NIAMS (1-877-226-4267) toll-free
(301) 495-4484
Fax: (301) 718-6366
TDD: (301) 565-2966
E-mail: niamsinfo@mail.nih.gov
Web Address: www.niams.nih.gov
 

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) is a governmental institute that serves the public and health professionals by providing information, locating other information sources, and participating in a national federal database of health information. NIAMS supports research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases and supports the training of scientists to carry out this research.

The NIAMS Web site provides health information referrals to the NIAMS Clearinghouse, which has information packages about diseases.


Related Information

References

Citations

  1. Choi HK, et al. (2004). Alcohol intake and risk of incident gout in men: A prospective study. Lancet, 363(9417): 1277–1281.
  2. Wortmann RL, Kelley WN (2005). Gout and hyperuricemia. In ED Harris Jr et al., eds., Kelley's Textbook of Rheumatology, 7th ed., pp. 1402–1429. Philadelphia: Elsevier Saunders.
  3. Hellman DB, Stone JH (2005). Arthritis and musculoskeletal disorders. In LM Tierney Jr et al., eds., Current Medical Diagnosis and Treatment, 44th ed., pp. 781–789. New York: McGraw-Hill.
  4. Klippel JH, et al. (1999). Gout section of Regional pain and monoarticular disorders. In Primary Care Rheumatology, pp. 117–124. London: Mosby.
  5. Rott KT, Agudelo CA (2003). Gout. JAMA, 289(21): 2857–2860.
  6. Bomalaski JS, Clark MA (2004). Serum uric acid-lowering therapies: Where are we heading in management of hyperuricemia and the potential role of uricase. Current Rheumatology Reports, 6: 240–247.
  7. Murray MT, Pizzorno JE Jr (2006). Gout. In JE Pizzorno Jr, MT Murray, eds., Textbook of Natural Medicine, 3rd ed., vol. 2, pp. 1703–1709. St. Louis: Churchill Livingstone Elsevier.

Other Works Consulted

  • Gravel J Jr, et al. (2007). Gout section of Rheumatology and musculoskeletal problems. In RE Rakel, ed., Textbook of Family Medicine, 7th ed., pp. 933–935. Philadelphia: Saunders Elsevier.

Credits

Author Shannon Erstad, MBA/MPH
Editor Kathleen M. Ariss, MS
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Stanford M. Shoor, MD - Rheumatology
Last Updated July 11, 2008

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