 gout what it really is  overview gout is a systemic disease ie condition that occurs throughout the body caused by the buildup of uric acid in the joints an elevated blood level of uric acid called hyperuricemia occurs when the liver produces more uric acid than the body can excrete in the urine or when a diet high in rich foods eg red meat cream sauces red wine produces more uric acid than the kidneys can filter from the blood over time uric acid in the blood crystallizes and settles in the joint spaces causing swelling inflammation stiffness and pain gout usually affects the first metatarsal phalangeal joint of the big toe hallux or the ankle joints incidence and prevalence according to the national institutes of health nih gout affects approximately 21 million people in the united states and is more common in men between the ages of 40 and 50 in women incidence increases after menopause the condition is rare in children and young adults causes and risk factors gout is caused by the buildup of uric acid in the joints approximately 18 of people who develop gout have a family history of the condition according to the national institute of arthritis and musculoskeletal and skin diseases diseases and conditions that increase the risk include diabetes obesity kidney disease and sickle cell anemia regularly drinking alcohol interferes with the removal of uric acid from the body and can increase the risk for developing gout other risk factors include the following exposure to lead in the environment high dietary intake of rich foods that contain purine eg cream sauces red meat sardines liver scallops medications that may interfere with the body s ability to remove uric acid eg aspirin diuretics levodopa used to treat parkinson s disease cyclosporine eg gengraf which is a medication used to suppress the body s immune system and prevent rejection after organ transplant also increases the risk for developing gout signs and symptoms gout usually develops in the joint of the first toe ie the big toe or hallux common symptoms include the following inflammation pain redness stiffness swelling touching or moving the toe may be intensely painful and patients often say that having as much as a bed sheet over the toe increases the pain symptoms of gout develop quickly sometimes in 1 day and typically occur in only one joint at a time rarely symptoms develop in two or three joints simultaneously if widespread symptoms occur the condition is probably not gout if left untreated gout can damage joints and cause disability diagnosis diagnosis of gout involves inserting a needle into the affected joint and drawing a sample of the fluid that lubricates the joint called synovial fluid the fluid is then analyzed under a microscope to determine if uric acid crystals are present to rule out joint infection the fluid also is examined for the presence of bacteria patients with gout have elevated blood levels of uric acid hyperuricemia but this condition may or may not be present during an acute attack treatment the goal of treatment is to decrease the amount of uric acid in the joints which helps to reduce symptoms and prevent further attacks if left untreated affected joints may be damaged causing disability in most cases gout is not treated unless it occurs frequently treatment may involve no steroidal antiinflammatories nsaids such as naproxen eg anaprox naprosyn and indomethacin eg indocin due to potentially severe gastrointestinal and cardiovascular side effects nsaids should only be used as instructed corticosteroids eg prednisone also may be taken orally or injected into the affected joint these medications usually resolve symptoms in about a week colchicine and probenecid benemid may be used alone or in combination eg colbenemid when other medications do not relieve symptoms these medications are most effective when taken within 12 hours of the onset of symptoms side effects include abdominal pain diarrhea nausea and vomiting prevention prevention is the best defense against gout medication eg small doses of nsaids colchicine allopurinol zyloprim probenecid may prevent continued accumulation of uric acid in the joints and further attacks avoiding alcohol and rich foods that are high in purine eg scallops sardines red meat sweetbreads gravy cream sauces also may help to prevent the condition other preventative measures include the following drink plenty of fluids especially water exercise regularly maintain a healthy diet and healthy body weight see a physician regularly  getting comfort  