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Gout is actually a type of inflammatory arthritis. It occurs when levels of uric acid build up in the blood. Gout is much more likely to occur in men over the age of 30, although some women develop gout after menopause. People with a strong family history of gout or those who have kidney disease are more likely to develop gout. As gout progresses, it can cause joint destruction.
As uric acid builds up in the body, patients develop tophi -- deposits of uric acid in the joints, cartilage, bones and under the skin. Tophi may begin as early as 10 or more years before other clinical signs of gout appear. Sometimes the first obvious sign is an acute gout attack of pain, redness and swelling in a joint; the big toe is nearly always involved, although gout can appear in other joints. The pain is due to the build-up of uric acid crystals. Patients may also complain of headaches, fatigue, and chills, particularity at night.
Gout probably has a genetic component, as family history is often a factor. Being obese or having metabolic syndrome (a pre-diabetic condition), increases the risk of gout. Organ transplants increase the risk of gout in some patients, as does chronic dehydration. Heavy alcohol use -- especially beer (but not red wine) -- is known to increase the incidence of gout. A diet high in red meat and seafood is also more likely to trigger gout.
Gout treatment involves both acute and chronic therapy (gout cannot be cured, but must be managed over the long term). During a gout attack, treatment is focused on lowering the uric acid levels with a medication specific to gout, called colchicine. It is also important to keep the patient well hydrated and treat pain and inflammation with appropriate medications. Over the long term, a medication called allopurinol is used to help lower uric acid levels. Patients are advised about dietary changes, such as limiting or eliminating alcohol, and lowering consumption of red meat and seafood.
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