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What is gout?

Gout causes attacks of painful inflammation in one or more joints. The pain can be severe. It affects about 1 in 200 adults. Men are more commonly affected than women. A first attack of gout typically develops in middle age, but it sometimes occurs in younger people.

What causes gout?

Gout is caused by a chemical in the blood called uric acid (urate). Uric acid is usually harmless, and is made in the body from certain foods. It is passed out with the urine. The amount of uric acid in the blood builds up in some people. From time to time the level may become too high. When the level of uric acid becomes high tiny grit-like crystals of uric acid may form. The crystals typically collect in a joint. This causes inflammation, swelling, and pain - a gout attack.

Note: some people have a high level of uric acid but do not form crystals or have gout. Also, rarely, some people with a normal level of uric acid have gout attacks. However, as a rule, the higher the level of uric acid, the greater the chance of forming crystals and developing gout.

In most cases there is no apparent reason for the build up of uric acid. In some people, the build up of uric acid may have a known cause. For example:

• If you drink too much alcohol it can cause uric acid to build up.
• Some medicines such as diuretics ('water tablets'), low dose aspirin, and some used as chemotherapy for cancer may raise the level of uric acid.
• More uric acid is made than usual in illnesses where the cells of the body have a rapid turnover. For example, severe psoriasis and some blood disorders.
• Certain foods may 'tip the balance' to raise your uric acid higher than normal. In particular, eating heart, herring, sardines, or mussels frequently may increase the level of uric acid. However, eating a normal balanced diet should not have much effect on the uric acid level.

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