Causes of Gout
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"Get Out the Gout"
As a result of high levels of uric acid in the blood,
needle-like urate crystals gradually accumulate in the joints. Urate crystals may be
present in the joint for a long time without causing symptoms. Infection, injury to the
joint, surgery, drinking too much, or eating the wrong kinds of foods may suddenly bring
on the symptoms, which include pain, tenderness, redness, warmth, and swelling of the
joint. In many cases, the gout attack begins in the middle of the night. The pain is often
so excruciating that the sufferer cannot bear weight on the joint or tolerate the pressure
of bedcovers. The inflamed skin over the joint may be red, shiny, and dry, and the
inflammation may be accompanied by a mild fever. These symptoms may go away in about a
week and disappear for months or years at a time. However, over the course of time,
attacks of gout recur more and more frequently, last longer, and affect more joints.
Eventually, stone-like deposits known as tophi may build up in the joints, ligaments, and
tendons, leading to permanent joint deformity and decreased motion. (In addition to
causing the tophi associated with gout, hyperuricemia can
also cause kidney stones, also called renal calculi or uroliths.)
Gout Causes - Demographics
Gout affects an estimated one million Americans. It most commonly afflicts men (800,000
men versus 200,000 women). Uric-acid levels tend to increase in men at puberty, and,
because it takes 20 years of hyperuricemia to cause gout symptoms, men commonly develop
gout in their late 30s or early 40s. Women more typically develop gout later in life,
starting in their 60s. According to some medical experts, estrogen protects against
hyperuricemia, and when estrogen levels fall during menopause, urate crystals can begin to
build up in the joints. Excess body weight, regular excessive alcohol intake, the use of
blood pressure medications called diuretics, and high levels of certain fatty substances
in the blood (serum triglycerides) associated with an increased risk of heart disease can
all increase a person's risk of developing gout.
The risk is greater in men, postmenopausal women, and people who use alcohol.
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