Gout – Patient Education Overview
Gout is a type of arthritis brought on by “glass-like” uric acid crystal deposits in the joints (most typically the large toe) with excessive uric acid in the blood. Our patient education guide will help assist with this painful type of arthritis.
Increased risks stem from:
- Excessive alcohol consumption
- Excessive consumption of red meat and fish
- Some diuretics (water pills)
Symptoms involving toes, feet, ankles, knees include:
- Shooting pains
Written by Barbara Hales, MDShow All
Doctors Who Treat Gout – Patient Education
Initial gout consultations with healthcare providers would most likely be to the physicians they have an ongoing relationship with:
- General Practitioner – Deals with prevention, discovery and treatment of illnesses in all age categories.
- Internist – Focuses on diagnosis, treatment and prevention of adult illness.
- Gynecologist – Deals with female health.
- Gerontologist – Deals with senior or elder health.
- Nurse Practitioner – Focuses on prevention, wellness and education of patients about health and health choices.
Once the diagnosis of gout has been made, a team approach will prevent any future damage, while alleviating pain. The team typically consists of:
Rheumatologist – A certified internist who specializes in treating the health of joints, muscles and bones with diagnosis and treatment of joint disorders, most notably arthritis. A rheumatologist may treat gout more aggressively than merely giving a diet or anti-inflammatory agents, and will be more knowledgeable about the latest treatment therapies for gout.
Orthopedist – Specializes on the health and disease of bones (skeletal system). Rarely, uric acid crystals from gout can create painful nodules (tophi) that prevent joint flexion. The orthopedist would be the one to surgically remove the tophi.
Cardiologist – Focuses on health of the heart and vascular system with diagnosis, and treatment of cardiovascular disorders. Patients with gout have a higher risk of heart disease or heart attacks, so susceptible individuals should be screened, examined and evaluated for heart problems and hypertension.
Nutritionist/Dietician – A specialist in required vitamins and daily supplements, as well as nutrition. A dietician will devise a meal plan that can help lower uric acid levels. The nutritionist or dietician also educates the patients on which foods to avoid with high uric acid levels that can cause gout flare-ups.
How to Prepare for Your Gout Doctor Visit
If gout is suspected, bring a list of questions with you to your physician’s office such as those listed in this patient education guide.
No preparation or fasting is necessary for a blood test screening the level of uric acid.
If you are expected to have a joint aspiration, it would be prudent to have a friend or relative drive you to and from the test site.
Questions to Ask Your Doctor About Gout
From your initial diagnosis throughout your treatment and care, you will have questions about your gout.
Below is a list of helpful questions for you and your doctor to discuss so you can make informed decisions about your condition.
Question About My Diagnosis
- What causes gout?
- Are there specific diagnostic tests that I need? How often should these tests be repeated?
- What are the symptoms of gout? How long does a gout attack last?
- Can I be cured of gout?
- Are there other systems affected by gout?
- What are the long-term risks of gout?
Questions About My Treatment
- What drugs treat gout?
- How soon after starting medication can I expect relief of my symptoms?
- Do I need to take the medication chronically or only when I experience an attack?
- What are the side effects of the treatment?
- Will other health problems develop if I don’t treat gout?
- Are there vitamins, herbs or supplements that prevent gout?
Questions About My Lifestyle & Family
- What foods or beverages should I avoid? Are there foods that trigger a gout attack?
- Are there physical activities that I should avoid?
- Can I work my normal job with this illness?
- Is gout genetic? What can my family do to avoid it?
- Is there an exercise plan that can keep me from having attacks?
- Are there over the counter medications that can trigger a gout attack?
Common Tests or Labs to Diagnose Gout
First and foremost, a physician will take a thorough history from the patient when diagnosing gout, (hyperlink “gout” to the main gout overview page) followed by a complete physical examination.
Additional tests will be taken to rule out related conditions and confirm the diagnosis of gout.
What is Tested?
|Blood Test||Uric acid levels||Blood is drawn from the arm into a syringe.||females =2.4-6.0 mg/dLmales = 3.4-7.0 mg/dL|
|Joint Fluid Aspiration (arthrocentesis)||Presence of uric acid or crystals||With a syringe, fluid is collected from between the joint where gout is suspected.A local anesthetic is typically used to numb the area first.||No crystals should be present|
|X-Rays of Joints||Looking for tophi (nodules), seen in late stages of goutRules out other forms of arthritis with eroded bone near joints||The joint area is exposed to the X-ray machine and a picture is taken.||No nodules visualizedNo punched out or eroded areas of bones|
Common Medications and Treatments for Gout
In addition to dietary modifications, patients with gout may need medication to help with flare-ups and pain.
It is important for patients with gout NOT to take aspirin or aspirin-based products, which are high in uric acid.
How it Works
|Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)||Decreases inflammationDecreases pain|
|Corticosteroids||Decreases inflammationDecreases painReserved for those who can’t take NSAIDs or colchicine|
|Colchicine||Pain reliefPrevents future attacks|
|Xanthine Oxidase Inhibitors||Decreases uric acid productionDecreases blood levels of uric acid|
|Uric Acid Eliminators||Increases uric acid removal by kidneys|
Written by Barbara Hales, MD