ABOVE PHOTO: 3-D imaging shows uric acid build up in a person with gout. Used with permission.1
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An estimated 9 million Americans are living with gout,2 but despite its prevalence, many misconceptions keep people from prioritizing getting the help they need to address this debilitating condition.
Why is it important to not ignore signs and symptoms of gout? For starters, gout is a serious form of arthritis and if it becomes out of control it can lead to permanent damage. When the body makes more uric acid than it should, or the kidneys do not remove as much as they should, uric acid builds up and tiny needle-like crystals begin to form.3 These crystals can accumulate anywhere in the body (called tophi) and cause permanent joint damage.4,5 The buildup of uric acid also puts you at risk for having a gout flare — which involves inflammation, redness, swelling, tenderness and intense pain.6
“When the pain of a gout flare goes away, many people assume the gout is gone, but without lowering your uric acid levels, these crystals will stay in your body and can continue to cause damage,” said Orrin Troum, M.D., clinical professor of medicine, board certified internist and rheumatologist. “It’s critical for people to realize that gout is a chronic condition linked to other conditions like cardiovascular disease and kidney disease. It is important to pay attention to signs and symptoms of gout, not just during a flare, in order to best address the disease.”
Here are three things you should know about gout, its symptoms, and why addressing the disease is so important:
• Uric acid can build up almost anywhere in the body. While some may believe that gout only affects the bones and joints, the truth is uric acid crystals can build up in your organs, like the kidneys, too. While crystals in your joints can cause severe pain during flares, the buildup of uric acid in your organs can lead to even more serious complications like chronic kidney disease.4,5,6,7
• Damage from gout can occur even when the pain is gone. The buildup of uric acid crystals can cause damage to the bones and joints, even if you’re not feeling pain.4,5,8,9 Getting rid of crystal buildup can help prevent future flares and permanent joint damage, making it important to be honest with your doctor about your symptoms and ensure your uric acid level is well controlled.
• Gout can become out of control. It’s important to keep track of your symptoms especially if you are taking gout medicine and you still have:10
• Continued gout flares, sometimes called attacks
• Tophi beneath the skin that aren’t getting better
Because it can be difficult to remember everything you want to share with your doctor, consider developing a list of your symptoms to discuss during your appointment. This can be helpful whether your visit is in person or taking place virtually — no one knows your symptoms better than you! You might even consider making a separate list of the questions you want to ask your doctor to ensure you’re addressing any possible concerns.
“Reach out to a gout specialist, often a rheumatologist, if you’re experiencing symptoms of gout or believe your gout may be out of control,” shares Dr. Troum. “It’s important not to let misconceptions about gout get in the way of getting the care you need.”
More information is available at Gout Revealed, which provides helpful information and stories of people living with the condition, as well as videos from gout specialists sharing some of the latest research, including the importance of recognizing and treating gout early.
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References: 1. Nicolaou S, et al. Dual-energy CT: a promising new technique for assessment of the musculoskeletal system. AJR Am J Roentgenol. 2012;199:S78-S86. 2. Chen-Xu M, et al. Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007-2016. Arthritis Rheumatol. 2019 Jun;71(6):991-999. 3. Doghramji PP, et al. Hyperuricemia and gout: new concepts in diagnosis and management. Postgrad Med. 2012;124:98-109. 4. Schett G, Schauer C, Hoffmann M, et al. Why does the gout attack stop? A roadmap for the immune pathogenesis of gout. RMD Open 2015;1:e000046. 5. Park JJ, et al. Prevalence of birefringent crystals in cardiac and prostatic tissues, an observational study. BMJ Open. 2014;4:1-6. 6. Neogi T. Gout. Ann Intern Med. 2016 Jul 5;165(1):ITC1-ITC16. 7. Singh J. & Cleveland J. Gout is associated with a higher risk of chronic renal disease in older adults: a retrospective cohort study of U.S. Medicare population. BMC Nephrol. 2019;20:93. 8. Edwards NL. Primer on the Rheumatic Diseases. 13th ed. New York, NY: Springer; 2008:241-249. 9. Rada B. Neutrophil Extracellular Traps and Microcrystals. J Immunol Res. 2017;e2896380:1-7. 10. Fitzgerald J, Dalbeth N, Mikuls T, et al. 2020 American College of Rheumatology Guideline for the Management of Gout. Arthritis Care Res (Hoboken). 2020.
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