Gout

This disorder, most often affecting middle-aged men, is caused by the accumulation of uric acid salts (urates) in the body, and is often inherited. Uric acid is a naturally occurring substance, an end-product of cellular break­down, which is normally excreted by the kidneys. Over­production or under-excretion of uric acid salts, results in a buildup of urates in the body. In some circumstances urate crystals form in and around the joints.

'It used to be thought that gout was caused by over-indulgence in rich food and drink, and although certain foods, and alcohol, can precipitate an attack this only happens in people who already have the predisposition.

Symptoms

The symptoms of a gout attack are sudden inflammation of a joint, swelling, redness, and extreme pain. The joint most commonly affected is the base of the big toe. The attacks often recur, urates build up in the body in other joints, and visible lumps known as tophi may arise in soft tissues in the skin of the hands, feet and ears.

Treatment

The attack can be treated by drugs which reduce inflammation, and by altering the diet if this is particularly rich or alcoholic. The basic chemical defect can also be treated with drugs which prevent the accumulation of uric acid. Several such drugs are available, and often have to be taken for the rest of the patient's life.