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What is gout and what causes it?

What is gout and what causes it?

Gout causes attacks of painful inflammation in one or more joints. It is a type of arthritis (although it is very different to the more common rheumatoid arthritis and osteoarthritis.

What is the science behind Gout?
Gout is caused by a chemical in the blood, called uric acid (urate). Uric acid is usually harmless and is made in the body. Most is passed out with the urine and some from the gut with the stools (faeces). In people with gout the amount of uric acid in the blood builds up. From time to time the level may become too high and tiny grit-like crystals of uric acid may form. The crystals typically collect in a joint.
The crystals irritate the tissues in the joint to cause inflammation, swelling and pain – a gout attack.

Why does uric acid build up?
Normally, there is a fine balance between the amount of uric acid that you make and the amount that you pass out in the urine and stools. This keeps the level of uric acid in the blood in check. However, in most people with gout, their kidneys do not pass out enough uric acid and the blood level may rise. They are said to be under-excreters of uric acid. Their kidneys usually work otherwise normally.
In some people, the build-up of uric acid may due to other factors – for example:

1. Drinking too much alcohol can cause uric acid to build up.
2. If you do not have enough vitamin C in your diet.
3. If you drink sugar-sweetened soft drinks high in fructose it can cause uric acid to build up. A recent research study found that having two drinks a day of a sugar-sweetened soft drink increased the risk of developing gout by 85%. (Drinks labelled as ‘diet’; or drinks containing artificial sweeteners were not found to increase the risk.) Fructose-rich fruits and fruit juices may also increase the risk.
4. Certain foods may ‘tip the balance&’ to raise your uric acid higher than normal. In particular, eating a lot of heart, herring, sardines, yeast extracts, or mussels may increase the level of uric acid. However, eating a normal balanced diet should not have much effect on the uric acid level.
5. Some medicines may raise the level of uric acid – for example, ‘water’ tablets (diuretics) such as Bendroflumethiazide, aspirin, and some chemotherapy medicines.
6. More uric acid is made than usual in illnesses where the cells of the body have a rapid turnover –
for example, severe psoriasis and some blood disorders.

People with certain other conditions have an increased risk of developing gout. These include:

Obesity, High blood pressure, Kidney damage, Diabetes mellitus, High cholesterol

Source : https://patient.info/foot-care/gout-leaflet