Overview
You wake up in the middle of the night, and your big toe feels as if it's on fire. It's hot, swollen and so tender that even the weight of a blanket on it seems intolerable. These problems could indicate an acute attack of gout or gouty arthritis a form of arthritis that's characterized by sudden, severe attacks of pain, redness and tenderness in joints.
Gout is a complex disorder that can affect anyone. Men are more likely to get gout than women are, but women become increasingly susceptible to gout after menopause.
Fortunately, gout is treatable, and there are ways to keep gout from recurring.
Signs and symptoms
The signs and symptoms of gout are almost always acute, occurring suddenly often at night and without warning. They include:
§ Intense joint pain. Gout usually affects the large joint of your big toe but can occur in your feet, ankles, knees, hands and wrists. The pain typically lasts five to 10 days and then stops. The discomfort subsides gradually over one to two weeks, leaving the joint apparently normal and pain-free.
§ Inflammation and redness. The affected joint or joints become swollen, tender and red.
Causes
The cause of gout is an inflammation in your joint resulting from an accumulation of urinate crystals. Uric acid is a waste product formed from the breakdown of pureness. These are substances found naturally in your body as well as in certain foods, especially organ meats such as liver, brains, kidney and sweetbreads and anchovies, herring, asparagus and mushrooms.
Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes your body either produces too much or excretes too little of this acid. In that case, uric acid can build up, forming sharp, needle-like crystals (urinate) in a joint or surrounding tissue that causes pain, inflammation and swelling.
Crystal deposits also cause another condition, known as false gout (pseudo gout). But rather than being composed of uric acid, pseudo gout crystals are made of calcium pyrophosphate dehydrate. And while pseudo gout can affect the big toe, it's more likely to attack large joints such as your knees, wrists and ankles.
Risk factors
The following conditions or circumstances can increase the chances you'll develop high levels of uric acid that may lead to gout:
Lifestyle factors. Excess consumption of alcohol is a common lifestyle factor that increases the risk of gout. Excess alcohol generally means more than two drinks a day for men and more than one for women. Gaining 30 pounds or more than your ideal weight during adulthood also increases your risk.
Medical conditions. Certain diseases make it more likely that you'll develop gout. These include untreated high blood pressure (hypertension) and chronic conditions, such as diabetes, high levels of fat and cholesterol in the blood (hyperlipidemia), and narrowing of the arteries (arteriosclerosis).
Certain medications. The use of trioxide diuretics used to treat hypertension and low-dose aspirin also can increase uric acid levels. So can the use of anti-rejection drugs prescribed for people who have undergone a transplant.
Genetics. About one out of five people with gout have a family history of the condition.
Age and sex. Gout occurs more often in men than it does in women, primarily because women tend to have lower uric acid levels than men do. After menopause, however, women's uric acid levels approach those of men. Men also are more likely to develop gout earlier usually between the ages of 40 and 50 whereas women generally develop symptoms after menopause.
Complications. Some people with gout develop a chronic form of arthritis, often with discolored deposits under the skin called tophi. A small number of people with gout also develop kidney stones
