Gout is one of the ancient diseases. Its prevalence has been rising since last few decades due to influence of western culture on lifestyle. It is caused due to uric acid crystals deposition in the joints and soft tissues. A high level of uric acid is not equivalent to gout. Blood uric acid level may be normal or low during acute attack. Classically this disease is characterized by recurrent acute severe joint pain, swelling with or without redness of the involved joint. Typically it affects joint at the base of great toe but any joint can be involved. An acute attack usually resolves in few days to few weeks with or without treatment. Many are at risk to develop second attack within one year. Repeated episodes lead into stage of chronicity, involving multiple joints. Untreated these patients develop nodular lesions over body which are called tophi. Tophaceous gout is difficult to treat. High levels of uric acid also lead to stone formation in kidneys and subsequent kidney damage. Men are at higher risk of gout than women. Obesity/overweight is one of the strongest risk factor to develop gout. Meat and sea food consumption increase uric acid level in the body due to their high purine content. Similarly increased alcohol consumption, sugar sweetened soft drinks are threats to beget gout. Contrary to traditional dietary approaches, purine rich vegetables like nuts, legumes, spinach, and cauliflower are not associated with increased risk for gout. Coffee consumption decrease risk for gout. Many medical conditions like obesity, heart, kidney diseases, psoriasis, organ transplantations etc elevate uric acid levels and result in development of gout. Few medications which are used in treatment of hypertension, diabetes, few of the painkillers are associated with increase risk.
Drugs which lower the uric acid level should be started after confirmation of the diagnosis either by demonstrating uric acid crystals in the joint fluid, or by X-rays or by other recently available techniques. Urate lowering drugs need to be taken indefinitely.
Similar to uric acid deposition, other crystals like calcium pyrophosphate, oxalates, lipids, cholesterol etc deposits can occur to provoke arthritis similar to gout attacks.