Gout is a common type of arthritis that causes intense pain, swelling, and stiffness in a joint. It usually affects the joint in the big toe.
Gout attacks can come on quickly and keep returning over time, slowly harming tissues in the region of the inflammation, and can be extremely painful. Hypertension, cardiovascular, and obesity are risk factors for gout.
Causes
Gout is caused initially by an excess of uric acid in the blood, or hyperglycemia. Uric acid is produced in the body during the breakdown of purines – 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, it can build up and form needle-like crystals that trigger inflammation and pain in the joints and surrounding tissue.
Risk factors
There are a number of factors that can increase the likelihood of hyperglycemia, 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.
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.
Recent trauma or surgery: Increases risk.
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 and diabetes.
Symptoms
Gout usually becomes symptomatic suddenly without warning, often in the middle of the night.
The main symptoms are intense joint pain that subsides to discomfort, inflammation, and redness.
Gout frequently affects the large joint of the big toe, but can also affect the forefoot, ankles, knees, elbows, wrists, and fingers.