An excess of uric acid in the blood brings on gout. Uric acid comes from two places -- produced by the body and from the diet. Any extra uric acid usually filters through the kidneys and gets passed in urine. If the body produces too much uric acid or fails to excrete it in the urine, crystals of sodium urate form in the joints and tendons. These crystals cause intense inflammation leading to pain swelling and redness.
What exactly causes gout to occur when it does? The most common factor that increases your chance of gout and gout attacks is excess consumption of alcohol, mainly beer. It used to be known as "the disease of kings" since it was mainly seen in wealthy men who drank and ate too much. Now we know it can occur in anyone and can be associated with injury or surgical procedures, hospitalizations, periods of stress, or reactions to fatty meals and certain drugs such as antibiotics. Gout may also occur in the presence of some tumors or cancers. There is also a relation between gout and kidney disorders, enzyme deficiencies, and lead poisoning. Gout may also accompany psoriasis and is common in patients with transplanted organs due to medications that are often needed. Susceptibility to gout is often inherited and is often associated with other common illnesses such as high blood pressure, diabetes, and obesity. Repeat attacks of gout are common if the body's uric acid level is not kept under control.
Pseudogout is a similar but generally less painful condition caused by calcium pyrophosphate crystals in the joints. While it can affect the large toe, it is more commonly seen in larger joints such as the knee, wrist, or ankle. More common after age 60 in both sexes, pseudogout is treated with anti-inflammatory agents.
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