Conditions InDepth: Gout
En Español (Spanish Version)

Gout is a form of arthritis caused by a build up of crystals in the joint. It most often affects the joint of the big toe, but can but it can affect other joints as well. Gout may occur in a single attack or become a recurrent problem. During acute attacks, gout can cause pain, swelling, and redness in the affected joint. Periods between acute attacks are usually symptom-free.

Over time, gout can cause permanent damage to the affected joints and the kidneys. Gout can also create a collection of crystals under the skin called tophi. The tophi is visible lump under the skin that can show up anywhere in the body and can become tender during acute attacks. Fortunately, these long term factors are less likely to occur with proper treatment. The earlier gout is detected and treated, the better it can be managed.

Causes
Gout is caused by the build-up of uric acid crystals in and around a joint. Crystals often form because of high levels of uric acid in the blood.

Uric acid is created and released into the blood during the breakdown of a substance in food called purines. The uric acid is then filtered out of the blood through the kidneys and passes out of the body through urine. Higher than normal levels of uric acid in the blood may be caused by:

  • Impaired ability to clear the uric acid in the kidneys may occur with kidney damage or disease
  • Increased production of uric acid which may be caused by one or more of the following
    • Excess consumption of foods high in purine like steak, seafood, and organ meats
    • Consumption of foods that encourage high uric acid levels such as alcohol or sugary drinks
  • Certain medications such as diuretics, salicylate containing medication (such as aspirin), niacin, or levodopa
  • Medical conditions such as high blood pressure, hypothyroidism, Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome



References:
Gout. American College of Rheumatology website. Available at: http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Gout. Updated September 2012. Accessed December 5, 2014.

Gout. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 28, 2014. Accessed December 5, 2014.

Pittman JR, Bross MH. Diagnosis and management of gout. Am Fam Physician. 1999;59(7):1799-1806.

Questions and answers about gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health_Info/Gout/default.asp#stages. Updated April 2012. Accessed December 18, 2014.

Last Reviewed May 2014



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