Gout - What Is It?
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• It is the most common cause of inflammatory joint disease in men over 40 years old • A joint in the big toe is the first joint affected in 70% of cases • In most patients only one joint is affected while in about 10% of patients it affects more than one joint • In a typical UK general practice of 2000 patients there may be 17 men and three women with gout |
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Gout occurs as a result of excess uric acid (urate) in the blood and tissues. After prolonged supersaturation of the tissues, crystals of urate can form in and around the joints and kidneys. If uric acid crystals enter the joint, they may trigger the development of inflamation. The affected joint becomes red, swollen and extremely painful and tender. Infrequently, stones (calculi) may form in the kidneys. Most patients with gout have high levels of urate in their blood because they do not pass enough in their urine. In most cases this is caused by an inherited peculiarity of the kidneys.
It can also be caused by high levels of uric acid in the diet or by some drugs eg. Diuretics (water tablets which are used in the treatment of high blood pressure or heart disease) . Much less commonly, patients produce too much uric acid in the first place, owing to an inherited metabolic abnormality or disorders associated with greatly increased production of cells in the body.
Gout patients have greater than average risk of developing vascular problems such as heart attacks and strokes.
