What is gout?
Gout is a common form of inflammatory arthritis – a condition affecting the joints and musculoskeletal system. It is the most common form of inflammatory arthritis in men, and although it is more likely to affect men, women become more susceptible to it after the menopause.
Gout commonly affects the base of the big toe. When affecting this area, the condition can also be referred to as podagra.
The condition is characterized by sudden and severe pains, redness and tenderness in the joints, most commonly in the base of the big toe. When affecting the big toe, gout can also be referred to as podagra.
These symptoms occur when uric acid, a product of ordinary metabolic processes, is deposited in the form of needle-like crystals in tissues and fluids within the body. Chalky deposits of uric acid known as tophi can also form as lumps under the skin surrounding the joints. Uric acid crystals can also collect in the kidneys, sometimes resulting in kidney stones.
At its most disabling, gout can cause permanent damage to joints and the kidneys. However, it normally takes a long period, around 10 years, without any proper treatment for the disease to reach this advanced stage, however.
The Centers for Disease Control and Prevention (CDC) report that 2.6 million Americans were affected by gout in 2005 and that this figure is projected to rise to 3.6 million by 2025.1
What causes gout?
Gout is caused initially by an excess of uric acid in the blood (hyperuricemia). Uric acid is produced in the body through the breakdown of purines – specific chemical compounds that are found in high amounts in certain foods such as meat, poultry and seafood.
Normally, uric acid is dissolved in the blood and is excreted from the body in urine via the kidneys. If too much uric acid is produced or not enough is excreted then it can build up and form the needle-like crystals that trigger inflammation and pain in the joints and surrounding tissue.
There are a number of factors that can increase the likelihood of hyperuricemia, and therefore gout:
- Age and gender: men produce more uric acid than women, though women’s levels of uric acid approach those of men after the menopause
- Genetics: a family history of gout increases the likelihood of the condition developing
- Lifestyle choices: alcohol consumption interferes with the removal of uric acid from the body. Eating a high-purine diet also increases the amount of uric acid in the body
- Lead exposure: chronic lead exposure has been linked to some cases of gout
- Medications: certain medications can increase the levels of uric acid in the body; these include some diuretics and drugs containing salicylate
- Weight: being overweight increases the risk of gout as there is more turnover of body tissue, which means more production of uric acid as a metabolic waste product. Higher levels of body fat also increase levels of systemic inflammation as fat cells produce pro-inflammatory cytokines
- Other health problems: renal insufficiency and other kidney problems can reduce the body’s ability to efficiently remove waste products, leading to elevated uric acid levels. Other conditions associated with gout include high blood pressure (hypertension), diabetes and hypothyroidism.
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