Once called the "disease of kings" because of its association with excess aristocratic consumption of mutton and mead, gout is certainly not a disease of the past.
Estimates suggest gout affects nearly 4% of the adult population in the US, with rates on the rise. Gout affects both men and women, though it is much more prevalent in men. Men are three times more likely than women to develop gout.
Unfortunately, there is no cure for gout. But the disease can be treated with medication and self-management strategies.
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Gout is a painful but common type of inflammatory arthritis. It's caused by the crystallization of uric acid within the joints. Uric acid a waste product of cells in the body.
Normally, your body excretes excess uric acid. But if you make too much uric acid, or if you don't excrete enough, the substance builds up in the blood. Gout attacks flare when uric acid builds up to an excessive level and starts to form crystals in the affected joint. This triggers inflammation and severe pain, sometimes with fever, muscle aches, and other flu-like symptoms.
Gout is not gout until symptoms occur. When they do, gout symptoms usually come on suddenly. While a gout attack can occur at any time, it is most likely to happen at night.
The first attack of gout usually involves only one joint, most commonly the big toe. However, a gout attack can occur in other joints, such as a knee, ankle, wrist, and joints between the many small bones that form the foot are also common sites. People who already have osteoarthritis—the most common form of arthritis—often experience gout attacks in the joints of the finger.
Within hours, the joint becomes red, swollen, hot, and painful, and extremely tender to the touch. Even light pressure on the joint may trigger intense pain.
Times when gout symptoms get worse are known as gout flares. Times when there are no symptoms are known as remission..
After the first attack of gout, later episodes are more likely to involve more than one joint at the same time. In some cases, if gout lasts for many years, uric acid crystals can collect in the joints or tendons, under the skin, or on the outside the ears, forming a whitish deposit called a tophus.
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What gout feels like can be different for each person. But pain, warmth, and tenderness in the affected joints are common. During a gout attack, the joint can become so painful and sensitive that even a bedsheet resting on the affected joint is agonizing.
During an attack, daily activities can become difficult. If the affected joint is in the foot, ankle, or knee, just walking can be challenging. Symptoms can also interfere with getting a good night's sleep.
Symptoms tend to be at their worst six to 12 hours after an attack of gout begins. Without treatment, the pain of gout can last for several days or longer.
The interval between attacks varies from person to person. Some people experience an attack of gout every few weeks, while others can go years between attacks. After several gout attacks, a joint may take longer to improve or it may stay inflamed and painful.