Gout

What is gout?

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Gout is an intensely painful form of arthritis. The word ‘arthritis’ simply means inflammation or pain in a joint. Gout is one of the common types of arthritis, affecting between 2-3 adults in every 100 people the UK [Kuo et al., 2015].
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People commonly think that gout is self-inflicted and caused by eating rich foods or drinking too much alcohol – lifestyles that were often associated with rich people or kings in past centuries like Henry VIII. While diet can play a part in making attacks of gout more likely, for most people gout is caused by their genetic makeup, their other health conditions, or the tablets they take (for more information see ‘Causes of gout’). 
Gout can affect men of any age, whereas women are more likely to develop gout after the menopause. More men than women are affected by gout. Attacks of gout usually happen suddenly and cause excruciating pain in the joints – often the big toe joint. The joint will typically be swollen, red and very tender. There are no definite answers about why gout is most common in the big toe joint, but there are several possible reasons relating to temperature, injury and osteoarthritis.
Attacks usually reach their most painful stage within 12-24 hours. They last between a few days and a few weeks and will start to get better even without treatment. An attack typically gets better with time. It is thought that this happens because the cells of the immune system stop reacting to the uric acid crystals, which means that the inflammation gets better*. Most people find that they need short-term treatment to reduce the pain and inflammation caused by attacks (see ‘Treating the pain and inflammation of attacks’). Over time, people may also develop white lumps called tophi under their skin – often around the elbows, feet or ears (for more information see ‘First symptoms and attacks’ and ‘Tests and diagnosis’).

*Mechanisms of inflammation in gout. Dalbeth N, Haskard DO. Rheumatology (Oxford). 2005 Sep;44(9):1090-6.


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Last reviewed December 2016
Last updated December 2016

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