A doctor and patient discuss gout

Gout: 10 Terms to Know

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Gout is caused by high levels of uric acid in the blood. Initially characterized by intense pain in the joint of the big toe, attacks of gout may cause pain or discomfort in one or more joints for days or weeks. In most cases, the longer the condition goes unchecked, the worse symptoms become. Luckily, there are several options for treatment following a proper diagnosis. One of the first steps of managing gout is understanding it. Here’s a look at ten important terms for understanding gout.

  1. Inflammatory arthritis: Gout is a type of inflammatory arthritis. This is a blanket term for arthritis conditions caused by inflamed joints. Other tissues (especially surrounding the affected joints) are often a part of this pain and discomfort as well. 
  2. Purines: Purines are a naturally occurring substance in the human body and in many foods. Seafood, steak, and organ meats are especially noted for their purine levels, as is yeast. Gout can be instigated or made worse by consuming large amounts of foods with high levels of purines. 
  3. Uric acid: When purines are broken down by the body, uric acid develops. Normal levels of uric acid are quite healthy—they protect the lining of the blood vessels and are considered an antioxidant. However, when the amount of uric acid in the blood gets too high, gout or other issues may result.
  4. Urate crystals: Urate crystals are a combination of calcium and uric acid that form sharp crystals. These are deposited around the body, especially in the joints—causing the pain and inflammation of gout. 
  5. Tophi: As gout progresses, additional complications may arise. Tophi are also urate crystals—but instead of building up in the joints, they form lumps under the skin. While these are not normally painful, they can be unsightly and indicative of very advanced gout.
  6. Rheumatologist: Rheumatologists are doctors trained specifically for the diagnosis and management of arthritis, as well as other conditions involving the musculoskeletal system. Your primary care physician may recommend a visit to a rheumatologist in order to achieve an accurate diagnosis and treatment plan if gout is suspected.
  7. Joint fluid test: In order to establish if the joint pain you are experiencing is indeed caused by gout, a joint fluid test can be useful. Using a needle, fluid from around the affected joint is removed and then examined to investigate the presence of urate crystals. 
  8. Colchicine: Treating gout not only requires managing uric acid levels, but also treating the pain of gout. Some patients benefit from nonsteroidal anti-inflammatories or corticosteroids that control the swelling and pain. Colchicine, however, is intended directly for the pain of gout. Taking small doses may even prevent future episodes. Unfortunately, the side effects are often so severe as to negate the usefulness of the medication. 
  9. Xanthine oxidase inhibitors: When the body is producing too much uric acid, xanthine oxidase inhibitors can be useful in treatment by stymying the amount the body makes, thus preventing future attacks of gout. 
  10. Uricosuric agent: Uricosuric agents like Probenecid can be used to encourage the kidneys to get rid of more uric acid, helping to lower the levels in the blood and preventing episodes of gout. It is important to note that although it lowers blood levels of uric acid, the levels in the urine increases, making kidney stones a potential side effect.

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