Gout is classified as a type of arthritis because it is initially and predominantly a disease of the joints.
Say the word "gout" and some people will think of a bloated king surveying the remains of a sumptuous feast, wine glass in hand, swollen foot propped on a pillow—looking for all the world like the dismal product of a grossly overindulgent life.
Gout Risk Factors
There are a couple of flaws in the conventional image decribed above. We know, for example, that gout doesn’t afflict only the privileged classes and that women, too, are susceptible, though a lot less than men.
But still there’s a good deal right with that picture. It correctly reflects many gout risk factors:
Age - Gender
About 90% of people afflicted with gout are men over 40.
Obesity in general, and in particular excessive weight gain in men between ages 20 and 40, has been shown to increase the risk of gout. In fact, about half of all gout sufferers are overweight.
Excessive Alcohol - Foods High In Purines
Alcohol abuse and so-called "binge" drinking are associated with gout, as is eating purine-rich foods such as:
- dried beans and peas
Other Gout Risk Factors
In addition, scientific surveys have shown links to an increased risk of gout with:
- occupational exposure to lead
- the use of certain drugs to control high blood pressure
- some surgical procedures
- family history (possibly a genetic predisposition)
Indeed, the prevalence of gout--the number of gout sufferers for each 100,000 people — is rising rapidly in the United States and other developed countries. Some authorities believe the increase is related to higher living standards.
Uric Acid Metabolism
Our fanciful image of a gouty Henry VIII (or other bloated monarch) can’t show, however, the one common denominator that ties together this mixed bag of risk factors: failure of the metabolic process that controls the amount of uric acid in the blood. For most people, the process works just fine. But in millions of Americans, uric acid metabolism has gone seriously haywire. As a result, they suffer from gout.
An Attack Of Gout
And suffer they do. An Englishman, Thomas Sydenham, writing in the 17th century, left this unfortunately all-too-accurate description of a typical attack of gout:
The victim goes to bed in good health. About two o’clock in the morning, he is awakened by a severe pain in the great toe; more rarely in the heel, ankle, or instep. The pain is like that of a dislocation. It becomes more intense. So exquisite and lively meanwhile is the feeling of the part affected, that it cannot bear the weight of the bed-clothes nor the jar of a person walking in the room. The night is passed in torture.