According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, gout occurs from a buildup of uric acid in the joints and soft tissue of the body. The foot is typically impacted starting with the big toe, but other joints can be affected in addition to or instead of the big toe, explains NIAMS. Gout may not present with symptoms initially, however, when symptoms appear, the condition causes pain, inflammation and permanent damage to the joints. Once gout affects a joint, a second or multiple flare-ups may occur in the same area, the Cleveland Clinic explains. Gout has differing risk factors and may be further complicated by lifestyle habits and health conditions.
Hyperuricemia
Excessive uric acid in the blood is referred to as hyperuricemia and is the primary cause of developing gout. The Chemocare website explains that the body produces uric acid and another substance called purines, which are compounds containing nitrogen made inside the body. When foods containing purine are ingested, the purine breaks down into uric acid, which increases acid levels in the tissues. Purine is not always a factor; sometimes the body creates too much uric acid alone and is unable to excrete the uric acid efficiently. The American College of Foot and Ankle Surgeons further notes that uric acid crystals form and are released into the joints, leading to foot swelling. Uric acid forms crystals at cooler temperatures, which further makes the foot optimal for gout to survive, since the extremities are the coolest part of the body.
Medical Conditions
The National Institute of Arthritis and Musculoskeletal and Skin Diseases states that gout commonly occurs in the geriatric population with the presence of medical conditions such as kidney insufficiency. The kidneys are responsible for eliminating waste and aid in filtering the blood. When the kidneys are compromised for varying reasons, the likelihood of excreting excess uric acid decreases. People with uncontrolled diabetes and problems with high fat and cholesterol in the blood are more susceptible to developing inflammation of the feet from gout. Additional conditions that increase risk for gout include the use of certain medications such as diuretics and aspirin. The Mayo Clinic explains that diuretics and aspirin inadvertently increase the level of uric acid because these medications do not flush uric acid out of urine in large quantity.
Genetics and Lifestyle Habits
Gout is more likely to occur in people with a family history of gout. The Cleveland Clinic notes that over 1 million Americans are affected yearly with the condition and lifestyle habits increase the risk. Nutrition habits that involve eating foods high in purines, such as liver, sardines and mushrooms, contribute to gout attacks. It is also noted that eating an inefficient amount of carbohydrates increases the risk of gout. The National Institute of Arthritis and Musculoskeletal and Skin Diseases notes that ketones form in the body and are released in the bloodstream when too little carbohydrate intake occurs. A condition known as ketosis then causes an increase in uric acid in the blood.
