What Is It?
Gout is a disorder characterized by too much uric acid in the blood and tissues. In gout, crystals of uric acid are deposited in the joints, where they cause a type of arthritis called gouty arthritis. They also can be deposited in the kidneys, where they can cause kidney stones.
There are three main causes of the high levels of uric acid that lead to gout:
A diet rich in chemicals called purines, because purines are broken down by the body into uric acid. Foods that contain purines include anchovies, nuts and organ foods such as liver, kidney and sweetbreads. Recent studies suggest that gout is more common among people who consume the most red meat, seafood, beer or liquor (though wine has little effect) and the intake of dairy products may be protective. For most people, however, diet plays a relatively small role in the risk of gout and levels of uric acid in the body. High production of uric acid by the body. This can happen for unknown reasons. It can occur in certain inherited genetic metabolic disorders, leukemia and during chemotherapy for cancer.
The kidneys do not excrete enough uric acid. This can be caused by kidney disease, starvation and alcohol use, especially binge drinking. This also can occur in people taking medications called thiazide diuretics, which are used to treat high blood pressure.
Obesity or sudden weight gain can cause high uric acid levels because the body's tissues break down more purines.
In some people, gout is caused by a combination of these factors. People with a family history of gout are more likely to develop the condition.
About 90% of patients with gout are men older than 40. Gout is quite rare in younger women and typically occurs in women many years after menopause.
The first attack of gouty arthritis usually involves only one joint, most commonly the big toe. However, it sometimes affects a knee, ankle, wrist, foot or finger. In gouty arthritis, the joint can become red, swollen and extremely tender to the touch. Typically, even a bed sheet brushing against the joint will trigger intense pain. After the first attack of gout, later episodes are more likely to involve several joints. Sometimes, if gout lasts for many years, uric acid crystals can collect in the joints or tendons, under the skin or on the outside the ears, forming a whitish deposit called a tophus.