Gout

Gout is a common type of arthritis that occurs when there is too much uric acid (sodium urate) in the blood, tissues, and urine. Uric acid is the end product of the metabolism of a class of chemicals known as purines. In people with gout, the body does not produce enough of the digestive enzyme uricase, which oxidizes relatively insoluble uric acid into a highly soluble compound. As a result, uric acid accumulates in the blood and tissues and, ultimately, crystallizes. When it crystallizes, uric acid takes on a shape like that of a needle and, like a needle, it jabs its way into the joints. It seems to prefer the joint of the big toe, but other joints can be vulnerable as well, including the mid-foot, ankle, knee, wrist, and even the fingers. Uric acid is more likely to crystallize at lower temperatures, which may explain why roughly 90 percent of gout attacks affect cooler extremities like the big toe. Acute pain is usually the first symptom. Then the affected joints become inflamed, almost infected-looking, red, swollen, hot, and extremely sensitive to the touch. Repeated attacks of gout over a long period of time can lead to joint damage.

Uric acid is a byproduct of certain foods, so gout is closely related to diet. Obesity and an improper diet increase the risk of developing gout. Gout has been called the rich man's disease, since it is associated with too much rich food and alcohol. But in fact it affects people from all walk of life, most commonly men between the ages of forty and fifty. It may be inherited or brought on by crash dieting, drinking, certain medications, overeating, stress, surgery, or injury to a joint.