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Disease of the MonthRheumatology & Immunology

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The pain and swelling associated

with gout are the result of the bodysresponse to the accumulation of urate

crystals in the affected joint.

Enlarged circle shows microscopicview of urate crystals.

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 the

weight of the blanket on it is nearly

intolerable.

If so, you might be experiencing anacute attack of gout (or gouty arthritis)

a form of arthritis that'scharacterized by sudden, severe

attacks of pain, redness andtenderness in joints.

Gout has been recognized for morethan 2,000 years, making it one of

humankind's oldest known diseases. Inthe past, gout was often known as "the

disease of kings" because it wasassociated with wealthy men who

overindulged in rich food and drink.Today, it's known that gout is acomplex disorder that can affect

anyone. In fact, it's a painful problemfor more than 2 million Americans.

It's true that men are more likely to get

gout, but women become increasinglysusceptible to it after menopause.

Fortunately, gout is treatable, and thereare ways to keep it from recurring.

Causes of Gout

Almost all people who have gout have too much uric acid in their blood, acondition called hyperuricemia. However, there are many people who havehyperuricemia but not gout.

Hyperuricemia is caused by one or both of the following conditions:

1. The kidneys can't get rid of uric acid fast enough.2. The body makes too much uric acid.

The use of diuretic medications or "water pills" can often cause hyperuricemia.Diuretics are used to get rid of excess body fluid and to lower high bloodpressure. However, diuretics can hamper the kidneys' ability to remove uricacid, thus raising uric acid levels in the blood.

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Inherited traits and other factors such as diet, weight, and alcohol use can alsoplay a role in causing gout.

Signs & Symptoms

Episodes develop very quickly, and the first episode often occurs at night.Episodes may be caused by the following:

Drinking too much alcohol Eating too much of certain foods

(Sardines, Anchovies, Broth, Gravy, Brains, Livers, Kidneys, and Sweetbreads) Surgery Sudden, severe illness

Crash diets

Joint injury

Chemotherapy

Diagnosis

Your doctor may withdraw fluid from the affected joint to detect crystals of uricacid within your white blood cells. He or she may also ask for a urine sampleand a blood test. A urine sample can provide information on how much uric acidyoure excreting. A blood test can indicate levels of uric acid in your blood.

Treatment

Gout treatment mainly consists of taking medication(s) and watching your diet.

The goals of treatment are to relieve pain, shorten the duration of inflammationduring an acute episode, prevent future episodes, and prevent joint damage.

Common medications that are used to treat gout are Colchicine, NSAIDs(Nonsteroidal Anti-Inflammatory Drugs), and Prednisone. These medicationsare aimed at relieving pain and swelling that is associated with gout.

Dietary & lifestyle changes can greatly decrease your risk for developing gout.Keep in mind the following:

Try to avoid or limit your intake of certain foods (see "Signs & Symptoms"list

above).

Obesity can be linked to high uric acid levels in your blood.

Limit your alcohol level as too much alcohol can also raise uric acid levels inyour blood.

Drink 10-12 eight-ounce glasses of non-alcoholic fluid daily to help "flush out"

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uric acid crystals from your body.

For more information on Gout,please visit these informative

sites.

Copyright 2002, Arthritis Foundation. All Rights Reserved.1998-2002 Mayo Foundation for Medical Education and Research. All rights reserved.

For other "Disease of the Month" features click below:Arthritis ~ Lupus ~Raynaud's Phenomenon

Last modified on: October 4, 2002

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