Gout occurs when urate crystals accumulate around your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines, substances that are found naturally in your body, as well as in certain foods, such as organ meats, anchovies, herring, asparagus and mushrooms.
Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes your body either produces too much uric acid or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needle like urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.
Gout is caused by too much uric acid in the blood. Most of the time, having too much uric acid is not harmful. Many people with high levels in their blood never get gout. But when uric acid levels in the blood are too high, the uric acid may form hard crystals in your joints.
Your chances of getting gout are higher if you are overweight, drink too much alcohol, or eat too much meat and fish that are high in chemicals called purines. Some medicines, such as water pills (diuretics), can also bring on gout.
Uric acid is generated as the body's tissues are broken down during normal cell turnover. Some people with gout generate too much uric acid (10%). Other patients with gout do not effectively eliminate their uric acid into the urine (90%). Genetics, gender, and nutrition (alcoholism, obesity) play key roles in the development of gout.
- If your parents have gout, then you have a 20% chance of developing it.
- British people are five times more likely to develop gout.
- American blacks, but not African blacks, are more likely to have gout than other populations.
- Intake of alcoholic beverages, especially beer, increases the risk for gout.
- Diets rich in red meats, internal organs, yeast, and oily fish increase the risk for gout.
- Uric acid levels increase at puberty in men and at menopause in women, so men first develop gout at an earlier age (after puberty) than do women (after menopause). Gout in premenopausal women is distinctly unusual.
Attacks of gouty arthritis can be precipitated when there is a sudden change in uric acid levels, which may be caused by :
· overindulgence in alcohol and red meats
· trauma
· starvation and dehydration
· IV contrast dyes
· chemotherapy
· medications :
- diuretics and some other hypertensive medications
- aspirin
- nicotinic acid
- cyclosporin A
- allopurinol and probenecid
- others
