Gout

Doctors hands

Overview

What is Gout?

Gout presents as episodic attacks causing painful and intense swelling in single joints, most often in the feet and the big toe, but it can affect other joints such as the wrists, elbows, knees and ankles. It occurs when the body produces excess uric acid that the kidneys cannot eliminate, resulting in the formation of crystal deposits in the joints. Excess uric acid may also cause kidney stones. Episodic gout attacks may be triggered by the consumption of: 

  • Shellfish, red meats and organ meats high in purines 
  • Alcohol in excess 
  • Food and drinks high in fructose 

In addition, some medications may also raise uric acid levels, such as certain diuretics and immunosuppressants used in organ transplants.  

More than three million Americans are affected by gout. It occurs more often in men and women who have finished menopause. Risk factors include obesity, high blood pressure or cholesterol, and diabetes.  

Symptoms

Symptoms of Gout

The primary symptoms of gout are episodic attacks of painful, swollen joints.  The affected site may also appear red or feel warm. Gout attacks may start at night and be followed by periods with no symptoms.  

Diagnosis

Diagnosis of Gout

Because other types of arthritis can resemble gout, a correct diagnosis is key to treatment. Blood tests to determine the level of uric acid are important but are most useful when performed in between attacks. Your rheumatologist may extract fluid from the affected joint to determine if crystals are present. Imaging tests such as X-rays, ultrasound and CT scans may show joint damage.  

Treatments

Treatments for Gout

Active gout attacks can be treated with different options such as a medication called colchicine, which can also prevent gout flares. Nonsteroidal anti‐inflammatory drugs (NSAIDs) can decrease inflammation and pain in joints. Corticosteroids, given orally or by injection, may be used by patients who cannot take NSAIDs. Patients who have repeated gout flares may be candidates for drugs that lower blood uric acid levels. New drugs to lower uric acid levels and to treat gout inflammation are under development. 

Colchicine

Medication which can also prevent gout flares

NSAIDs

Can decrease inflammation and pain in joints

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Corticosteroids

For patients who cannot take NSAIDs

Clinical Trials

Clinical Trials

The rheumatologists at Saint John’s Physician Partners have been integrally involved in the development of medications that treat inflammatory arthritis conditions for decades. They were involved in the clinical trials that led to the approval at the Food and Drug Administration (FDA) for medications that treat rheumatoid arthritis (RA), psoriatic arthritis (PsA)ankylosing spondylitis (SpA), osteoarthritis, and other bone and skin conditions like osteoporosis and psoriasis advanced therapies, some of which are biologic treatments. 

Specialists

Gout Specialists

Orrin Troum, M.D. and Amro Elbalkhi, M.D. provide consultation, diagnosis, and treatment for rheumatic diseases including inflammatory arthritis (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis), scleroderma, myositis, gout, lupus, osteoarthritis, and osteoporosis. The Medical Doctors of Saint Johns strive to provide world class care and a personalized treatment plan for all patients and their families.  

1301 20th St., Suite 280, Santa Monica, CA 90404

1301 20th St., Suite 280, Santa Monica, CA 90404

1301 20th St., Suite 280, Santa Monica, CA 90404

1301 20th St., Suite 280, Santa Monica, CA 90404

1301 20th St., Suite 280, Santa Monica, CA 90404

1301 20th St., Suite 280, Santa Monica, CA 90404