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Gout is a type of arthritis. It occurs when uric acid builds up in the blood and causes inflammation in the joints. Acute gout is a painful condition that usually affects only one joint. Chronic gout refers to repeated episodes of pain and inflammation. More than one joint may be affected.

Causes

Gout is caused by having a higher than normal level of uric acid in the body. This can occur if:

• • • The body produces too much uric acid.

• • • The body has difficulty getting rid of uric acid.

• • • When too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to become inflamed, causing pain, swelling and elevated temperature in the area.

The exact cause is unknown. Gout may run in families. The problem is more common in males, postmenopausal women, and people who drink alcohol. As people age, gout becomes more common.

The condition may also occur in people with:

• • • Diabetes

• • • Kidney disease

• • • Obesity

• • • Sickle cell anemia and other anemias

• • • Leukemia and other blood cancers

• • • Gout may occur after taking medications that interfere with the removal of uric acid from the body. People who take certain medications, such as hydrochlorothiazide and other diuretics, may have a higher level of uric acid in their blood.

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Gout Attack

An attack of gout can occur suddenly and can often cause you to wake up in the middle of the night with the feeling that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the sheet may seem intolerable.

Gout symptoms may come and go, but there are ways to control symptoms and prevent flare-ups.

Gout Symptoms

• • • Gout in the big toe

• • • GoutEnlarge image

• • • Signs and symptoms of gout almost always occur suddenly, often at night.

These include:

• • • Severe joint pain. Gout usually affects the big toe, but can occur in any joint. Other commonly affected joints include the ankles, knees, elbows, wrists and fingers. The pain is likely to be most severe within the first four to 12 hours after it starts.

• • • Persistent discomfort. After the most severe pain goes away, some joint discomfort may remain, which may last for a few days or weeks. Later attacks are likely to last longer and affect more joints.

• • • Swelling and redness. Affected joints become swollen, tender, warm and red.

• • • Limited range of motion. As gout progresses, you may not be able to move your joints normally.

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Gout Diet

It is important to change eating habits, as this can directly influence the amount of circulating uric acid and, consequently, the deposition of crystals in the joint, and to treat underlying diseases that can also favor the development of gout when left untreated, such as hypertension and diabetes, for example.

What should the diet be like?

To alleviate the symptoms of gout and prevent new attacks, it is important to prioritize the consumption of natural foods rich in fiber, vitamins and minerals, such as fruits, vegetables, whole grains and legumes.

It is also recommended to reduce the intake of foods rich in purines, such as red meat, fish, poultry and seafood, as they increase uric acid levels in the blood. In addition, about 2 liters of water per day should be drunk, as this favors the reduction of uric acid levels in the blood.

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Complications

People with gout may develop more serious conditions, such as the following:

• • • Recurrent gout. Some people may never experience signs and symptoms of gout again. Others may experience gout several times a year. Medications can help prevent gout attacks in people who have recurrent gout. If left untreated, gout can erode and destroy a joint.

• • • Advanced gout. Untreated gout can cause deposits of urate crystals to form under the skin in nodules called tophi. Tophi can develop in various areas, such as the fingers, hands, feet, elbows or Achilles tendons found at the back of the ankles. Tophi are usually not painful, but they can become inflamed and tender during gout attacks.

• • • Kidney stones. Urate crystals can build up in the urinary tract of people with gout and cause kidney stones. Medications can help reduce the risk of kidney stones.