What Causes Gout?

Gout (medically known as medically arthritis urica), is a painful and severe inflammatory joint disease caused by elevated uric acid. Gout is a common metabolic disease that affects more men than women.

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Cause

Gout is characterized by a high blood level of uric acid over a prolonged period of time. This condition is known as hyperuricemia. Most cases of gout are caused by reduced kidney function. This impairs the ability to excrete uric acid. There is also a congenital predisposition.

Excessive consumption of meat, seafood, and alcohol, along with drinks containing fructose, can also lead to an increase in uric acid. This causes painful inflammations and uric acid crystals to form in the joints.

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Frequency

Gout is a common metabolic disease and can be found in many families. Gout is more common in men than in women, as estrogen favors the excretion via the kidneys of uric acids. Consequently, 9 out 10 people affected are men.

Signs and Symptoms

A high blood uric acid level does not cause symptoms. The symptoms begin to manifest after a while when crystals build up in the joints.

Gout attacks can often occur overnight and are extremely painful. The affected joint becomes extremely sensitive and reddensified, and is very sensitive to touch. The affected joint’s mobility is also severely restricted. Most often, the base joint of your big toe is affected. However, other joints may also be affected. Gout flares are usually limited to one joint. Rarely, multiple joints can be affected simultaneously.

The intercritical phase is the period between two acute attacks of gout. It is often asymptomatic. Over a longer time, persistent uric acids deposits around the joints (called tophi) may develop. These appear as small nodules beneath the skin that shimmer white against taut skin. Tophi can also be opened, and the accumulated uric acids crystals can be seen oozing out like a toothpaste.

Gout flare-ups can cause severe inflammation and permanent pain.

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Diagnosis

A medical history and physical exam are required to diagnose the condition. Particularly, the joints are checked for swelling, mobility and signs of gout flares (deposits or tophi).

A blood test can be used to rule out other conditions and determine the level uric acid. Although elevated uric acid is not sufficient to diagnose gout, it can be used as a marker.

If joint fluid from an acutely swollen or irritated joint is collected, and uric acids crystals are detected in it, gout can be confirmed. A pseudogout, or a condition that mimics gout can also be diagnosed. Mixed crystal arthropathy can be used in the event of pseudogout and gout.

Additionally, X-rays can be taken to determine if there has been any bone damage.

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Changes in Diet

The basis for hyperuricemia treatment is a change in diet. Particularly, avoid purine-rich foods like meat, fish, and seafood. Soft drinks and alcohol containing fructose should also be avoided. The best way to make the changes is nutrition counseling. A change in diet is not always enough.

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