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Gout and Hyperuricemia

Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Melissa Conrad Stöppler, MD

• What is gout? What is hyperuricemia?
• Who is affected by gout?
• What are gout causes and risk factors?
• What are gout symptoms and signs?
• How is gouty arthritis diagnosed?
• What is the treatment for gout?
• Foods to eat and foods to avoid with gout
• Gout medications
• What does the future hold for patients with gout and hyperuricemia?
• Gout and Hyperuricemia At A Glance
• Pictures of Gout – Slideshow
• Patient Discussions: Gout – Symptoms Experienced
• Find a local Rheumatologist in your town

Fast Facts on Gout

Gout is one of the most painful forms of arthritis. It occurs when too much uric acid builds up in the body. The buildup of uric acid can lead to:

• Sharp uric acid crystal deposits in joints, often in the big toe
• Deposits of uric acid (called tophi) that look like lumps under the skin
• Kidney stones from uric acid crystals in the kidneys

For many people, the first attack of gout occurs in the big toe. Often, the attack wakes a person from sleep. The toe is very sore, red, warm, and swollen.

Gout can cause:

• Pain
• Swelling
• Redness
• Heat
• Stiffness in joints

In addition to the big toe, gout can affect the:

• Insteps
• Ankles
• Heels
• Knees
• Wrists
• Fingers
• Elbows

A gout attack can be brought on by stressful events, alcohol or drugs, or another illness. Early attacks usually get better within three to 10 days, even without treatment. The next attack may not occur for months or even years.

See more symptoms and signs of gout

SOURCE: “Fast Facts About Gout,” National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Department of Health and Human Services

What is gout? What is hyperuricemia?

Gout is a disease that results from an overload of uric acid in the body. This overload of uric acid leads to the formation of tiny crystals of urate that deposit in tissues of the body, especially the joints. When crystals form in the joints, it causes recurring attacks of joint inflammation (arthritis). Gout is considered a chronic and progressive disease. Chronic gout can also lead to deposits of hard lumps of uric acid in the tissues, particularly in and around the joints and may cause joint destruction, decreased kidney function, and kidney stones.

Gout has the unique distinction of being one of the most frequently recorded medical illnesses throughout history. It is often related to an inherited abnormality in the body’s ability to process uric acid. Uric acid is a breakdown product of purines that are part of many foods we eat. An abnormality in handling uric acid can cause attacks of painful arthritis (gout attack), kidney stones, and blockage of the kidney-filtering tubules with uric acid crystals, leading to kidney failure. On the other hand, some people may only develop elevated blood uric acid levels (hyperuricemia) without having manifestations of gout, such as arthritis or kidney problems. The state of elevated levels of uric acid in the blood without symptoms is referred to as asymptomatic hyperuricemia. Asymptomatic hyperuricemia is considered a precursor state to the development of gout. The term gout refers the disease that is caused by an overload of uric acid in the body, resulting in painful arthritic attacks and deposits of lumps of uric acid crystals in body tissues.

Gouty arthritis is typically an extremely painful attack with a rapid onset of joint inflammation. The joint inflammation is precipitated by deposits of uric acid crystals in the joint fluid (synovial fluid) and joint lining (synovial lining). Intense joint inflammation occurs as the immune system reacts, causing white blood cells to engulf the uric acid crystals and chemical messengers of inflammation to be released, leading to pain, heat, and redness of the joint tissues. As gout progresses, the attacks of gouty arthritis typically occur more frequently and often in additional joints.

Who is affected by gout?

Approximately 5 million people in the United States suffer from gout. (Did you know that none other than Benjamin Franklin had terribly painful gouty arthritis?) Gout is nine times more common in men than in women. It predominantly attacks males after puberty, with a peak age of 75. In women, gout attacks usually occur after menopause.

While an elevated blood level of uric acid may indicate an increased risk of gout, the relationship between hyperuricemia and gout is unclear. Many patients with hyperuricemia do not develop gout (asymptomatic hyperuricemia), while some patients with repeated gout attacks have normal or low blood uric acid levels. In fact, the blood level of uric acid often lowers during an acute attack of gout. Among the male population in the United States, approximately 10% have hyperuricemia. However, only a small portion of those with hyperuricemia will actually develop gout.

Next: What are gout causes and risk factors?

Gout – Symptoms Experienced

For gout, what were the symptoms and signs you experienced?

The following Patient Discussions have not been medically reviewed. See additional information.

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