What causes gout? Gout is a joint disorder (arthritis) characterized by sudden and severe attacks of joint pain, tenderness, and redness, often involving the base of the big toe. However, it can also affect the ankles, knees, wrists, and hands. The pain is usually most severe in the first 12 to 24 hours, which is followed by a few days or weeks of discomfort in the involved joint.

If untreated, gout can lead to irreversible joint damage. Uric acid crystals are deposited in the soft tissues around the joints, causing nodules called tophi to develop. Uric acid may also be deposited in the kidneys, causing kidney stones and reduced kidney function.

What Causes Gout?

Gout is characterized by the accumulation of urate crystals in the joint, causing inflammation and severe pain. Urate crystals form when uric acid levels in the blood increase beyond normal levels. Uric acid is a normal by-product of metabolism, which usually passes out in the urine. When the body produces too much uric acid or fails to eliminate it through the urine, uric acid levels can build up and crystallize to form needle-like structures. When these surround the joints, inflammation, swelling and intense pain occur.

Risk factors associated with gout attacks include:

Diet	High purine and high protein diet consisting of internal organs, red meats, oily fish, and yeast Excessive intake of alcoholic beverages, such as beer
Certain Medications	Aspirin Diuretics Some anti-hypertensive medicines Niacin nicotinic acid Cyclosporin A Allopurinol Probenecid
Medical Conditions and Illness	Obesity Dehydration Rapid weight loss Diabetes High blood pressure Heart disease Trauma
Surgery	Gastric bypass surgery
Inherited Factors	Children of parents who have gout have a 20% risk of developing it Pre-existing conditions that cause high blood uric acid levels, such as Lesch-Nyhan syndrome or Kelley-Seegmiller syndrome Enzyme deficiency that causes failure to control uric acid levels
Age and Sex Factors	Gout is more common in men aged 40 to 50 years After menopause, women's uric acid levels increase

When to See a Doctor

Consult a doctor if you experience:

• Sudden, severe pain involving one joint
• Swollen, red, warm, tender joints

It is important to see a doctor even if the pain subsides because uric acid deposited on the joint can cause serious damage. Treatment includes medicines that can prevent future attacks and reverse uric acid buildup.

What Are the Treatments for Gout?

Since you have known what causes gout, you should work on how to get rid of it with the methods. 

Medications used to treat gout are used for acute attacks and for preventing future attacks. They may also reduce the risk of complications, such as the formation of tophi from the urate crystal deposition.

1. Medications

• Nonsteroidal anti-inflammatory drugs or NSAIDs. These help control pain and inflammation. Over-the-counter drugs include ibuprofen (Advil, Motrin) and naproxen (Aleve). Prescription NSAIDs include indomethacin (Indocin). Risks include bleeding, ulcers, and stomach pain.
• Colchicine. Colchicine (Colcrys) is effective in reducing gout pain, especially if used when symptoms appear. However, it has intolerable side effects, including diarrhea, nausea, and vomiting.
• Corticosteroids. Drugs such as prednisone help control pain and inflammation. They may be taken as oral medications or they may be injected into the joint. They are generally used by patients who cannot take NSAIDs and colchicine. Side effects include poor wound healing, thinning of bones, and reduced immune function. Low doses are usually used to reduce the risk of side effects.

Medications used to prevent complications from gout include:

• Medications to block production of uric acid. These include xanthine oxidase inhibitors such as allopurinol (Lopurin, Aloprim) and febuxostat (Uloric), which limit uric acid production, thus reducing uric acid levels. Side effects include rash, low blood count (allopurinol), nausea and abnormal liver function (febuxostat).
• Medications to improve uric acid elimination. These include probenecid (Probalan), which improves the kidneys' ability to excrete uric acid from the body. Side effects include rashes, stomach ache, and kidney stone formation.

Medications are proven to effectively treat gout, but some easy home treatments can also help provide symptom relief and promote healing.

2. Home Remedies

• Apple Cider Vinegar

Apple cider vinegar is a popular treatment for headache and acidic stomach, but it also helps relieve gout pain. Combine 1 teaspoon (or up to 2 tablespoons) of apple cider vinegar to a glass of water and take 2 to 3 times a day.

• Ginger Root

There are various ways to use ginger root, which is known for its anti-inflammatory properties. You can drink it twice daily with equal amounts of turmeric powder and fenugreek powder, dissolved in warm water. Or, make ginger root tea and drink at least once a day. Others add ginger root to their recipes, eat small pieces of raw ginger root daily, or apply a paste made from ginger root and water on the affected joint once daily.

• Baking Soda

Baking soda helps lower uric acid and relieves pain. Just mix half a teaspoon of baking soda with a glass of water and drink four times daily for two weeks. However, people who are older than 60 years should not take it more than three times daily. People who have high blood pressure should not take baking soda.

• Lemon Juice

Lemon juice helps neutralize excess uric acid in the blood. Mix lemon juice with half a teaspoon of baking soda and mix in a glass of water after the fizzing stops. Drink immediately. You can also add lemon juice to a glass of water and drink it thrice a day.

• Cherries

Cherries contain anthocyanins, which have antioxidant properties that can help reduce inflammation and minimize flare-ups. Eat 15 to 20 pieces of cherries or drink black cherry juice daily.

• Epsom Salt

Epsom salt is rich in magnesium, which can help improve your heart and lower your high blood pressure. Soaking painful body parts in warm water with two cups of Epsom salt relaxes the muscles and relieves pain. You can do this once a week, but for severe pain, you can do it twice or thrice a week.

• Activated Charcoal

Activated charcoal absorbs uric acid and taking a charcoal bath twice or thrice a week can relieve pain. To prepare your bath, prepare a paste from charcoal powder and water, and add water for soaking the affected body parts. You can also apply the paste directly over the affected joint. An alternative treatment is to take activated charcoal capsules as oral treatment, after consulting with your doctor.

How to Prevent Gout

Knowing what causes gout and how to treat gout is good, but the best thing is to prevent it before head.

1. Keep Your Fluid Intake High

Try to drink 8 to 16 cups (2 to 4 liters) of fluids daily, at least half of which should be water. Limit sweetened beverages.

2. Maintain a Healthy Weight

Lose excess weight to lower your uric acid levels. However, avoid fasting or losing weight rapidly, which can temporarily increase uric acid levels.

3. Eat a Balanced Diet

Avoid eating foods that are high in purine and protein, as well as alcohol. Here are some suggestions:

Avoid	Fish sources	Anchovies, herring, sardines, codfish, mussels, scallops, trout, haddock
	Meat sources	Liver, kidney, heart, ox, sweetbreads, venison, rabbit, bacon, veal, meat extracts (gravy, stock cubes)
	Other sources	Yeast/extracts, beer, cauliflower, mushrooms, asparagus, beans, peas, spinach, sugary drinks, fatty foods
Limit	Chicken, pork, beef, duck Crab, oysters, lobster, shrimp Lunch meats Liquor
Enjoy	Water, whole grains, fat-free or low-fat dairy products, eggs, peanut butter, nuts, rice, noodles, pasta and potatoes, fruits and vegetables, fruit juice

Watch a video to know more about gout diet: