The presence of too much uric acid in the blood, which can cause gout. Uric acid is a byproduct of the breakdown of purines, substances found throughout the body and in such foods as liver, dried beans and peas, and anchovies. Ordinarily, uric acid is filtered out of the bloodstream by the kidneys and is excreted from the body in urine. However, uric acid can build up in the blood when the body manufactures increasing amounts of it, the kidneys fail to filter out enough of it, or a person eats too many foods high in purines.
Most people with hyperuricemia do not develop gout, but gout can develop if excess uric acid crystals form in the body. For many people, the first attack of gout occurs in the big toe, causing soreness, pain, redness, warmth, and swelling. Gout can also affect the insteps, ankles, heels, knees, wrists, fingers, and elbows.
To diagnose gout, doctors ask the patient about his or her symptoms, medical history, and any family history of gout. To help confirm the diagnosis, they may test for hyperuricemia and the presence of uric acid crystals in the joint fluid.
Doctors typically treat an acute gout attack with nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids such as prednisone, and colchicine. Doctors try to prevent recurring episodes of gout by prescribing medications that lower uric acid levels in the blood. These include sulfinpyrazone (brand name Anturane), probenecid (Benemid), and allopurinol (Zyloprim).