About arthritis.

Author:Bomar, Marilee G.
Position:Disease/Disorder overview

In ancient times gout was associated with people of wealth who could afford to indulge in rich foods and beverages. More than 2,000 years later, we know that gout is one of more than a hundred types of arthritis. You may also get gout called gouty arthritis.

Gout tends to strike without warning in the middle of the night with symptoms of sudden, intense pain and swelling in a single joint. Most frequently, the joint at the base of the first (big) toe is involved. The right treatment can control most gout cases. However, diagnosing gout can be a challenge. It is, in fact, often misdiagaosed.

Who gets gout?

Approximately 2 million Americans have gout. It commonly occurs in men who are between the ages of 30 and 50. The risk for women increases following menopause. Gout affects 6%-7% of older men. Only rarely does it affect young adults and children.

Causes and contributing factors

Gout occurs when uric acid crystals are deposited in a joint and cause pain and inflammation. Uric acid is a waste product formed from the breakdown of' purines, substances that are found naturally in our tissues as well as in certain foods. Normally, excess uric acid dissolves in the blood, passes through the kidneys, and leaves the body in urine. Sometimes, however, uric acid levels in the body are higher than normal (a condition called hyperuricemia). When levels are high in synovial fluid, the lubricating fluid produced by the synovium (the tissue that lines the joints), sharp-edged, needle-shaped crystals of uric acid can begin to form in joint spaces.

Hyperuricemia can be the result of an increase in the product of uric acid, which makes it impossible for the kidneys to get rid of it quickly enough. Or, more likely, it can be the result of an inability of the kidneys to adequately remove amounts of uric acid. This in ability can have many causes. Some of these causes are surgery, toxins present in the kidneys, and vascular and other diseases that damage kidney tissue.

Hyperuricemia itself is not a disease and does not need to be treated if it is not causing symptoms. It is a condition that is dangerous only when excess uric acid forms crystals that build up in joint spaces, causing pain, inflammation, and redness. When these symptoms occur, gout is suspected.

Diet as a factor

Excessive consumption of alcohol-most notably, of beer and hard liquor such as whiskey-may be a factor in causing gout. All types of alcohol increase the production of uric acid. At the...

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