Gout is a common cause of joint inflammation that affects 5 million adults in the U.S. Men are nine times more likely to develop gout than women. Gout is caused by an abnormal ability to process uric acid. Uric acid is formed during the breakdown of purines in the food we eat. Uric acid crystals formed in the blood deposit in joint fluid triggering inflammation that causes an extremely painful attack of gouty arthritis. The small joint at the base of the big toe is the most common site of an acute attack of gout. The ankles, knees, wrists, fingers and elbows are also often involved in gout. Gout can also cause kidney stones and kidney failure. Chronic gout may lead to the deposit of masses of uric acid crystals in soft tissues of the body called tophi. These deposits may be found anywhere in the body but are common at the tips of the elbows and in the fingers.

Although it is known that an abnormal ability to process uric acid plays an important role in gout, the exact cause of gout is not known. Many people have elevated uric acid blood levels but only a small percentage will develop gout. Some people suffering from an acute gout attack will have normal or low uric acid blood levels. The inability to process uric acid is often inherited. Other risk factors include excessive weight gain (especially in youth), moderate to heavy alcohol use, high blood pressure and abnormal kidney function. Certain medications including aspirin and thiazide diuretics (used to lower blood pressure) can also cause gout. A recent study has shown abnormally low thyroid hormone levels in people with gout.

Dietary changes can help reduce uric acid blood levels. Sufferers should avoid eating purine-rich foods such as shellfish and meat (especially organ meats like liver). Alcohol and fructose in soft drinks increase the risk of gout attacks. Dairy foods seem to reduce gout attacks. Adequate water intake can also help reduce the risk of attacks. Weight reduction also appears to lower risk of gout.

Medications taken to treat gout include NSAIDs such as indomethacin and naproxen to reduce inflammation in acute gouty arthritis. Colchicine and corticosteroids are also used to reduce inflammation during an acute attack. Probenecid increases the excretion of uric acid by the kidneys. Allopurinol reduces uric acid production. Febuxostat, recently approved by the FDA, also reduces uric acid production and is used to treat chronic gout.

Reference: http://www.medicinenet.com/gout/article.htm

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