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What is it?

Gout is a condition caused by uric acid crystals forming in the body. When the crystals deposit in joints, inflammation results in severe pain, especially in the feet. The most frequently affected joint is the big toe but gout can also occur in the hands, wrists, knees and feet. During these attacks, uric acid deposits may build up in cartilage, tendons and other soft tissues. They may also form lumps called tophi under the skin and may accumulate in the kidneys causing kidney stones and kidney damage.

Crystals deposit when uric acid levels in the body are high because the kidney is unable to remove it from the blood quickly enough. A defect in metabolism may result in either overproduction of uric acid or a reduced ability of the kidneys to eliminate it. If people have either of these problems then eating a diet high in purines which are converted into uric acid will increase their risk of developing gout. For lists of such foods check the links at the end of this article. Gout develops more frequently in people with type 2 diabetes, obesity, sickle cell anaemia and kidney disease, or following therapy with drugs that interfere with uric acid excretion such as aspirin, cyclosporin and thiazide diuretics.

What tests are used?

  • Synovial fluid analysis may show crystals of uric acid in fluid from an affected joint.
  • An elevated level of uric acid may be detected in blood.
  • Kidney function may be monitored via blood tests to check for damage caused by the crystals.

X-rays of the affected joints may show tophi (uric acid deposits) and damage indicative of gouty arthritis.

What treatments exist?

Anti-inflammatory drugs are used to reduce the pain of gout, while other treatments are aimed at reducing uric acid levels, resulting in fewer and less severe attacks. Drugs, such as probenecid or sulfinpyrazone, which lower uric acid and allopurinol, which blocks the enzyme that produces uric acid, may be used. Reducing alcohol intake and consumption of high-purine foods is often required. Increasing fluid intake helps the kidneys flush out uric acid.

Last Review Date: April 27, 2023

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