Have you ever woken up at night with a sudden, burning pain in your big toe? Does the joint feel hot, swollen, and so sensitive that even a blanket feels too heavy? If so, it might be gout – a disease that is often misunderstood, ignored, or treated too late.
As a rheumatologist with years of experience, I have seen how timely gout diagnosis can change a person’s quality of life. In this article, I will explain what gout is, how to recognize it, why uric acid is so important, and what the treatment options are. I will also include real-life examples from my practice and answer frequently asked questions.
Dr. Aleksandra Bukina
What is gout?
Gout is an inflammatory joint disease caused by elevated levels of uric acid in the blood. When uric acid crystallizes, it deposits in the joints, causing severe pain, swelling, and inflammation. Most commonly, it affects the big toe joint, but other joints – such as knees, ankles, and wrists – can also be impacted.
Uric acid is formed when the body breaks down purines – substances found both in our cells and in certain foods (e.g., red meat, seafood, alcohol). If there is too much uric acid or the kidneys cannot excrete it efficiently, problems begin.
Symptoms that indicate gout
A gout attack usually starts suddenly, often at night. Typical symptoms include:
- Sharp, burning pain in a single joint
- Swelling and redness
- Joint sensitivity – even a light touch hurts
- Limited range of motionA patient who came to me complaining of sudden swelling in their toe initially thought it was a bruise. Only after uric acid tests and a gout diagnosis did it become clear – it was a classic gout attack.
How is gout diagnosis performed?
Gout diagnosis is based on clinical symptoms, laboratory tests, and sometimes joint fluid examination. The main indicator is the level of uric acid in the blood – if it exceeds $360$ $\mu$mol/l for women or $420$ $\mu$mol/l for men, there is an increased risk.
It is also important to rule out other joint diseases, such as rheumatoid arthritis or infections. Sometimes X-rays or ultrasounds are performed to assess the condition of the joints.
Treatment – how to control gout?
Gout treatment includes:
- Relieving acute attacks – using anti-inflammatory drugs (e.g., colchicine, ibuprofen).
- Reducing uric acid levels – with medications such as febuxostat or allopurinol.
- Lifestyle changes – reducing purine-rich foods and alcohol, and increasing water intake.For example, a patient who experienced regular attacks reported no pain within 6 months after controlling their uric acid and starting medication. They also followed a diet and reduced alcohol consumption.
Prevention – how to avoid gout?
Prevention is possible if risk factors are controlled:
- A healthy diet low in purines
- Regular physical activity
- Weight management
- Adequate water intake
- Regular uric acid testingPatients with chronic gout should be monitored by a rheumatologist to adjust therapy and oversee the progression of the disease.If you suspect you have gout, do not wait for the next attack. Timely gout diagnosis, uric acid control, and a consultation with a rheumatologist in Riga can be decisive. Apply for a visit at “Republikas laukuma klīnika” – our experienced specialists will help you regain your quality of life.
FAQ
Gout is controllable if treatment and lifestyle recommendations are followed. While a complete cure (in the sense of removing the underlying metabolic tendency) is not possible, attacks can be entirely prevented, and the disease can be put into long-term remission.
No, women can also develop gout, especially after menopause when estrogen levels decrease. Estrogen helps the kidneys excrete uric acid; therefore, its decline increases the risk of crystal formation.
Partially – through diet, weight loss, and proper hydration. However, diet usually only reduces uric acid levels by about 10–15%. In more severe or chronic cases, medication is necessary to prevent joint damage.
