A form of acute arthritis that causes severe pain and swelling in the joints. It most commonly affects the big toe, but may also affect the heel, ankle, hand, wrist, or elbow.
Gout usually comes on suddenly, goes away after 5-10 days, and can keep recurring. Gout is different from other forms of arthritis because it occurs when there are high levels of uric acid circulating in the blood, which can cause urate crystals to settle in the tissues of the joints.
Uric acid, which is found naturally in the blood stream, is formed as the body breaks down waste products, mainly those containing purine, a substance that is produced by the body and is also found in high concentrations in some foods, including brains, liver, sardines, anchovies, and dried peas and beans. Normally, the kidneys filter uric acid out of the blood and excrete it in the urine. Sometimes, however, the body produces too much uric acid or the kidneys aren’t efficient enough at filtering it from the blood, and it builds up in the blood stream, a condition known as hyperuricemia. A person’s susceptibility to gout may increase because of the inheritance of certain genes or from being overweight and eating a rich diet. An additional factor is occupational or environmental; it is now known that chronic exposure to high levels of lead decreases the body’s excretion of urates, allowing uric acid to accumulate in the blood.
Hyperuricemia doesn’t always cause gout. Over the course of years, however, sharp urate crystals build up in the synovial fluid of the joints. Often, some precipitating event, such as an infection, surgery, the stress of hospitalization, a stubbed toe, or even a heavy drinking binge can cause inflammation. White blood cells, mistaking the urate crystals for a foreign invader, flood into the joint and surround the crystals, causing inflammation–in other words, the redness, swelling, and pain that are the hallmarks of a gout attack.