Gout incidence is at an all-time high—but unfortunately, many people with gout are not receiving effective treatment. In fact, 2 out of 3 gout patients aren’t happy with how their physician is treating it. During a gout flare, many people attempt to tough out their symptoms with home remedies—or they make frequent trips to the emergency room to manage pain.
A wide range of health professionals—including rheumatologists, primary care physicians, ER physicians, nurse practitioners, physician assistants, nephrologists, podiatrists, orthopedic surgeons, and endocrinologists—treat gout patients, so there are often inconsistencies in gout diagnosis and treatment that can affect patient outcome.
Not all patients are diagnosed with gout in the initial stage.
This means that treatment plans can differ depending on the patient’s symptoms and stage of gout.
There are a number of risk factors for gout. The more risk factors a person has, the greater the risk for developing gout. When examining a patient, take the following risk factors into consideration to ensure a proper diagnosis:
- Hyperuricemia – Classified as a serum uric acid above 6.8 mg/dL, hyperuricemia is the metabolic background for developing gout. For those with gout, the target goal is a serum uric acid level less than 6.0 mg/dL, and lower in those with advanced disease.
- Family History – Gout clusters in families and is more prevalent in certain Asian sub groups (e.g., Pacific Islanders, Māoris). One in four people with gout has a family history of the disease.
- Age – Gouty arthritis can occur in anyone at any age, but it typically develops in men over age 45 and post-menopausal women.
- Gender – Gout affects men more than women, although once women are post-menopausal, their rates of gout increase almost (but not quite) to the same level as men.
- Ethnicity – The incidence of gouty arthritis and comorbid conditions varies by ethnicity. For example, in the U.S., Hispanics and African Americans who have features of metabolic syndrome are more likely to develop gout.
- Obesity – Someone with a Body Mass Index (BMI) of 30 or higher is considered obese and is at higher risk for gout.
- Comorbidities – Gout is associated with other comorbidities, including cardiovascular disease, diabetes and renal disease.
- Joint Injury – Urate crystals are more likely to form in a joint that was previously damaged. Recent injuries can also bring on a flare.
- A High-Fructose Diet – High-fructose corn syrup is added to many foods and drinks—it causes uric acid to increase. Typically found in sweetened soft drinks and juices;
- Use of Certain Medications – This especially includes diuretics or water pills and certain anti-rejection medications used in transplant patients.
Join the Gout Specialist Network
The Gout Education Society believes that continuing education for medical professionals and their staff is crucial when it comes to keeping up with the latest in gout treatment, diagnosis and management.
In October 2012, the American College of Rheumatology (ACR) published its long anticipated “Guidelines for the Management of Gout.” In September 2015, ACR expanded on the existing guidelines and released new classification criteria about gout.
With gout on the rise, it is essential that all patients, especially those touched by gout, are knowledgeable about this serious disease. You can always learn more from your doctor during regular visits. Take a stand on gout!