What is Gout?

Gout

What is gout?

Gout is a fairly common condition that can cause bad pain and swelling in your joints, usually in your big toe joint. The disease occurs when tiny crystals of a chemical called urate build up in your joints.

Urate is a chemical in your blood. It's made in the body when you digest certain foods. It's usually in the form of a harmless liquid that passes out of the body in your urine. But in some people, the amount of urate in the blood builds up.

Source:
Lin KC, Lin HY, Chou P.
The interaction between uric acid level and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study.
Journal of Rheumatology. 2000; 27: 1501-1505.

¹ It starts to form tiny crystals, which can collect in a joint. The crystals can cause

inflammation
If your skin or some other part of your body becomes red, swollen, hot or sore, we say it is inflamed. It means that your body is trying to protect you from germs, from something in your body tissues that can hurt you (like a thorn or sliver), or from things that cause allergies (allergens). Inflammation is part of the way the body heals an infection or injury.

inflammation and pain.

Gout normally affects only one joint at a time. The main big toe joint (which doctors call the first metatarsophalangeal joint) is most often affected. But you can also get gout in any of the joints in your:

Feet
Ankles
Knees
Wrists
Fingers
Elbows.

Gout can happen when you have too much urate in your blood, but not everyone with high levels of urate gets gout.

Source:
Campion EW, Glynn RJ, DeLabry LO.
Asymptomatic hyperuricemia: risks and consequences in the Normative Aging Study.
American Journal of Medicine. 1987; 82: 421-426.

² However, the more urate you have in your blood, the more likely you are to get an attack of gout.

Here are some of the reasons why some people get more urate in their blood:

Drinking too much alcohol. Studies show that drinking beer and liquor, but not wine, increases your chances of getting gout.

Source:
Choi HK, Atkinson K, Karlson EW, et al.
Alcohol intake and risk of incident gout in men: a prospective study.
Lancet. 2004; 363: 1277-1281.

⁴
Eating a lot of certain foods, especially red meat or some seafood. But low-fat dairy products, like skim milk, may protect you from getting gout. They help your body process urate faster.

Source:
Choi HK, Atkinson K, Karlson EW, et al.
Alcohol intake and risk of incident gout in men: a prospective study.
Lancet. 2004; 363: 1277-1281.

⁴

Source:
Choi HK, Atkinson K, Karlson EW, et al.
Purine-rich foods, dairy and protein intake, and the risk of gout in men.
New England Journal of Medicine. 2004; 350: 1093-1103.

⁵
Being very overweight (

obesity
If your body stores more energy than you need for daily functioning, this can make you overweight. The excess energy is stored in your fat cells. If your weight goes above a certain level, doctors call this obesity. Obesity is considered a medical condition. The excess weight can be a strain on your bones and joints. And if you are obese, you're more likely to get other diseases. Doctors have developed a scale for telling how much excess weight you have. This measure, called the body mass index (BMI), depends on your height.

obese).

Source:
Culleton BF.
Uric acid and cardiovascular disease: a renal-cardiac relationship?
Current Opinion in Nephrology and Hypertension. 2001; 10: 371-375.

⁶

Source:
Bryan E.
Are gout and increased uric acid levels risk factors for cardiac disease?
April 2002. Centre for Clinical Effectiveness evidence report. Available at http://www.mihsr.monash.org/cce/res/pdf/b/805.pdf (accessed on 15 December 2008).

⁷
Having certain illnesses. These include heart disease,

high blood pressure
Your blood pressure is considered to be high when it is above the accepted normal range. The usual limit for normal blood pressure is 140/90. If either the first (systolic) number is above 140 or the lower (diastolic) number is above 90, a person is considered to have high blood pressure. Doctors sometimes call high blood pressure "hypertension."

high blood pressure,

diabetes
Diabetes is a condition that causes too much sugar to circulate in your blood. It happens when your body stops making a hormone called insulin (type 1 diabetes) or when insulin stops working (type 2 diabetes).

diabetes and

high cholesterol
If you've been told that you have high cholesterol it usually means that your total cholesterol level is 240mg/dL or higher. But doctors also look at the amount of good (HDL) and bad (LDL) cholesterol you have in your blood. Having high levels of bad cholesterol can make it more likely that you'll get certain diseases in your heart and arteries.

high cholesterol.

Source:
Culleton BF.
Uric acid and cardiovascular disease: a renal-cardiac relationship?
Current Opinion in Nephrology and Hypertension. 2001; 10: 371-375.

⁶

Source:
Bryan E.
Are gout and increased uric acid levels risk factors for cardiac disease?
April 2002. Centre for Clinical Effectiveness evidence report. Available at http://www.mihsr.monash.org/cce/res/pdf/b/805.pdf (accessed on 15 December 2008).

⁷ If you have an attack of gout, your doctor may test you for these diseases. But they are not caused by gout.
Taking certain medications, such as

diuretics
Diuretics are a type of medicine that reduce the amount of fluid in your body. The extra fluid is removed in your urine.

diuretics (water tablets) for high blood pressure and regular aspirin in low doses.

Source:
Snaith M.
ABC of rheumatology: gout, hyperuricaemia and crystal arthritis.
BMJ. 1995; 310: 521-524.

⁸

Sources for the information on this page:

Lin KC, Lin HY, Chou P.The interaction between uric acid level and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study.Journal of Rheumatology. 2000; 27: 1501-1505.

Campion EW, Glynn RJ, DeLabry LO.Asymptomatic hyperuricemia: risks and consequences in the Normative Aging Study.American Journal of Medicine. 1987; 82: 421-426.

Lin KC, Lin HY, Chou P.The interaction between uric acid level and other risk factors on the development of gout among asymptomatic hyperuricemic men in a prospective study.Journal of Rheumatology. 2000; 27: 1501-1505.

Choi HK, Atkinson K, Karlson EW, et al.Alcohol intake and risk of incident gout in men: a prospective study.Lancet. 2004; 363: 1277-1281.

Choi HK, Atkinson K, Karlson EW, et al.Purine-rich foods, dairy and protein intake, and the risk of gout in men.New England Journal of Medicine. 2004; 350: 1093-1103.

Culleton BF.Uric acid and cardiovascular disease: a renal-cardiac relationship?Current Opinion in Nephrology and Hypertension. 2001; 10: 371-375.

Bryan E.Are gout and increased uric acid levels risk factors for cardiac disease?April 2002. Centre for Clinical Effectiveness evidence report. Available at http://www.mihsr.monash.org/cce/res/pdf/b/805.pdf (accessed on 15 December 2008).

Snaith M.ABC of rheumatology: gout, hyperuricaemia and crystal arthritis.BMJ. 1995; 310: 521-524.

This information was last updated on Jan 09, 2009

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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