Henry VIII playing cards at court

When we think of gout, images of Henry VIII, and the books of Charles Dickens come to mind. Like typhoid, Gout is a disease that is now confined to the history books, an illness the result of an age of ignorance and squalor. But you would be wrong, people all over the world today still suffer from this painful illness which is almost a direct result of our modern, and often stressful lifestyles.

Diagram of foot with gout
What is gout?
It turns out that gut is a type of arthritis, in which crystals of sodium urate produced by the body can form inside your joints.

The most common symptom of gout is sudden and severe pain in the joint, along with swelling and redness.

Strangely, the joint of the big toe is usually affected, but gout can develop in any joint.

Symptoms can develop rapidly to their worst point in 6-24 hours and usually last for 3-10 days (this is sometimes known as a gout attack). After this time, the joint will start to feel normal again and any pain or discomfort should eventually disappear completely.

Most people with gout will have further attacks in the future.

What causes gout?

x-ray of feet with gout
What is gout?
Gout is caused by a buildup of uric acid in the blood. Uric acid is a waste product made in the body every day and excreted mainly via the kidneys. It forms when the body breaks down chemicals in the cells known as purines.

If you produce too much uric acid or excrete too little when you urinate, the uric acid builds up and may cause tiny crystals to form in and around joints.

These hard, needle-shaped crystals build up slowly over several years. You will not know this is happening.

The crystals may cause two problems:

Some may spill over into the soft lining of the joint (synovium), which causes the pain and inflammation associated with gout.

Some pack together to form hard, slowly expanding lumps of crystals (tophi) which can cause progressive damage to the joint and nearby bone; this eventually leads to irreversible joint damage which causes pain and stiffness when the joint is being used.

Factors which increase your risk of gout include:

man eating and drinking poor choice of foods
What is gout?
Age and gender. Gout is more common when you get older and is three-to-four times more likely in men.

Being overweight or obese.

Having high blood pressure or diabetes.

Having close relatives with gout (gout often runs in families).

Having long-term kidney problems that reduce the elimination of uric acid.

Having a diet rich in purines; such as frequently eating sardines and liver.

Drinking too much beer or spirits – these types of alcoholic drinks contain relatively high levels of purines.

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