Gout

Gout is a form of inflammatory arthritis that is caused by the buildup of too much uric acid in the body. Uric acid comes from the breakdown of substances called purines. Normally, uric acid dissolves in the blood and passes through the kidneys and out of the body in urine. However, in some cases uric acid can build up in the blood and lead to sharp uric acid crystal deposits in joints, often in the big toe, causing pain, swelling, redness, and stiffness. A gout attack can be brought on by stressful events, alcohol or drugs, or another illness.

Gout occurs when too much uric acid builds up in the body. The buildup of uric acid can lead to:

  • Sharp uric acid crystal deposits in joints, often in the big toe
  • Deposits of uric acid (called tophi) that look like lumps under the skin
  • Kidney stones from uric acid crystals in the kidneys.

For many people, the first attack of gout occurs in the big toe. Often, the attack wakes a person from sleep. The toe is very sore, red, warm, and swollen.

Gout can cause:

  • Pain
  • Swelling
  • Redness
  • Heat
  • Stiffness in joints.

In addition to the big toe, gout can affect the:

  • Insteps
  • Ankles
  • Heels
  • Knees
  • Wrists
  • Fingers
  • Elbows.

A gout attack can be brought on by stressful events, alcohol or drugs, or another illness. Early attacks usually get better within 3 to 10 days, even without treatment. The next attack may not occur for months or even years.

In many people, gout initially affects the joints of the big toe (a condition called podagra). But many other joints and areas around the joints can be affected in addition to or instead of the big toe. These include the insteps, ankles, heels, knees, wrists, fingers, and elbows. Chalky deposits of uric acid, also known as tophi, can appear as lumps under the skin that surrounds the joints and covers the rim of the ear. Uric acid crystals can also collect in the kidneys and cause kidney stones.


Who is Likely to Develop Gout?

Gout occurs in 8.4 of every 1,000 people. It is rare in children and young adults. Men, particularly those between the ages of 40 and 50, are more likely to develop gout than women, who rarely develop the disorder before menopause. People who have had an organ transplant are more susceptible to gout.

You are more likely to have gout if you:

  • Have family members with the disease
  • Are a man
  • Are overweight
  • Drink too much alcohol
  • Eat too many foods rich in purines
  • Have an enzyme defect that makes it hard for the body to break down purines
  • Are exposed to lead in the environment
  • Have had an organ transplant
  • Use some medicines such as diuretics, aspirin, cyclosporine, or levodopa
  • Take the vitamin niacin.

Uric Acid

Uric acid is a substance that results from the breakdown of purines. A normal part of all human tissue, purines are found in many foods. Normally, uric acid is dissolved in the blood and passed through the kidneys into the urine, where it is eliminated.

If there is an increase in the production of uric acid or if the kidneys do not eliminate enough uric acid from the body, levels of it build up in the blood (a condition called hyperuricemia). Hyperuricemia also may result when a person eats too many high-purine foods, such as liver, dried beans and peas, anchovies, and gravies. Hyperuricemia is not a disease, and by itself it is not dangerous. However, if excess uric acid crystals form as a result of hyperuricemia, gout can develop. The crystals form and accumulate in the joint, causing inflammation.


Further Information on Gout


Further Reading

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