The pain and misery of gout, the oldest known form of arthritis, was first described in ancient Egyptian medical texts in 2640 B.C. Historically, gout has been referred to as the disease of kings because people often incorrectly link it to the high intake of food and wine, to which only the rich and powerful had access. We now recognize that gout can affect anyone and that it has many more risk factors, including genetics, than previously thought.
Gout is the most common type of inflammatory arthritis and can cause the abrupt onset of pain, swelling and warmth in one or more joints. It affects approximately four percent of people in the United States and can occur in those who have high blood concentrations of uric acid. Uric acid is a byproduct of the metabolic breakdown of certain foods. High levels of uric acid can develop due to conditions that cause an overproduction of uric acid or conditions that impair the ability to eliminate uric acid.
Not everyone with an elevated uric acid level has symptoms of gout. However, when symptoms do occur, gout typically causes intense swelling, warmth, and pain in one or more joints. Approximately 60 to 70 percent of gout attacks affect a person’s big toe. Acute gout flare-ups can occur intermittently with asymptomatic periods in between. Sometimes the flare-ups may resolve without intervention. However, in the later stages of untreated gout, flare-ups can become more frequent, involve more joints, cause more joint damage, and even lead to deformities such as nodules that develop in the skin around the joints.
The following are risk factors that can increase the chance of developing gout:
- Being male
- Being obese
- Having a family history of gout
- Over consuming alcohol, especially beer and hard liquor.
- Eating a diet high in purines (certain meats, seafood, high fructose corn syrup)
- Having kidney disease
- Having heart failure
- Having hypertension
- Having inherited genetic mutations
- Having a malignant disease
- Taking certain medications that interfere with uric acid levels (diuretics, laxatives and some immunosuppressive drugs)