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Gout is a form of inflammatory arthritis that causes sudden, severe pain, swelling and tenderness - most often in the large joint of the big toe. However, gout isn't limited to the big toe; it can affect other joints including the feet, ankles, knees, hands, wrists, elbows and sometimes soft tissue and tendons. It usually affects only one joint at a time, but it can become chronic and, over time, affect several joints.
A gout attack can last anywhere from a few days to two weeks, if untreated. Prompt medical attention can usually resolve gout symptoms within a few hours or a couple of days. Some people never experience a second gout attack; others enjoy a long period with no gout symptoms only to have gout reappear just as suddenly as it struck the first time.
An estimated 6.1 million Americans have experienced at least one gout attack. The disease most commonly affects men and can manifest anywhere from age 30 onward. Women get gout too, although they are at a slightly lower risk, and it usually appears after menopause.
Gout results from a condition called hyperuricemia, which simply means you have a high level of uric acid in the blood. Uric acid forms when the body breaks down waste products called purines. Some people's bodies produce too much uric acid; other people's kidneys can't eliminate it quickly enough.
A gout attack occurs when uric acid that isn't eliminated from the body forms crystals in the fluid that lubricates joint linings, causing painful joint swelling and inflammation. If gout is left untreated, these crystals can form tophi - lumps in the affected joints or surrounding tissues.
For centuries, people believed gout was caused by eating rich foods and drinking too much. Today we know that although diet and excessive drinking aren't the true causes of gout, they do play a role in triggering a gout attack. Certain foods high in purines such as seafood and organ meats, along with alcohol - especially beer - can raise uric acid levels and trigger a gout attack. In fact many people report a first attack after a night of heavy drinking.
Medications may also be to blame. Diuretics, or "water pills," which are frequently used to lower blood pressure, boost urine production, but they may also lower the kidneys' ability to remove uric acid. That, in turn, can raise uric acid levels in the blood and cause a gout attack. Gout caused by diuretics can be "cured" simply by adjusting the dosage. Gout attacks also can be triggered by conditions such as injuries and infections.