Gout is caused by abnormal metabolism of "uric acid" in the body or impaired kidney function in excreting uric acid, leading to elevated levels of uric acid in the blood. Uric acid sodium salts accumulate in the joints, causing joint inflammation, pain, swelling, and deformity. The higher the blood uric acid concentration and the longer the duration, the greater the chance of developing gout. However, not all individuals with high uric acid levels and joint pain have gout, making accurate diagnosis crucial.

Normal blood uric acid levels should be below 7.0 mg/dL. Approximately 15% of the population in Taiwan have elevated uric acid levels, and the percentage is even higher, around 50%, in individuals who frequently consume alcohol.

Symptoms of Gout:

1. Acute Gout: Often occurs at night and affects joints, causing redness, swelling, warmth, and severe pain. Acute gout attacks most commonly affect the big toe joint, but they can also occur in the foot, ankle, knee, wrist, and hand joints. During acute gout attacks, around 80% of individuals have elevated blood uric acid levels.
2. Chronic Gouty Arthritis: Uric acid crystals can deposit in joints, subcutaneous tissue, and even visceral organs, forming nodules known as tophi. These tophi can cause joint deformities and chronic arthritis.

Factors that Contribute to Gout:

• Genetic Factors: A family history of gout or high uric acid levels increases the risk for children.
• Gender: Gout is more common in males than females, but the risk increases in postmenopausal women.
• Age: Gout is most common in individuals aged 40 to 60, but the onset age has been decreasing recently, and even individuals in their 20s may develop gout.
• Obesity: Excess body weight is often associated with higher uric acid levels due to decreased urine output from increased sweating.
• Diet: Consuming purine-rich foods, overeating, and excessive alcohol consumption can elevate uric acid levels and increase the risk of gout.

Treatment and Self-Care for Gout:
The general principles for managing gout involve controlling acute and chronic attacks and preventing the deposition of urate crystals through medications and dietary modifications.

• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) relieve pain and inflammation. Urate-lowering medications focus on inhibiting uric acid formation or promoting uric acid excretion. Colchicine can be used for acute gout attacks and prophylaxis, but it may have side effects such as diarrhea, which can be managed by adjusting the dosage.
• Exercise: Avoid intense physical activity, as it can increase sweating and hinder uric acid excretion. Intense exercise can also generate excess lactic acid, further impeding uric acid elimination.
• Hydration: Drinking 2000 to 4000 mL or more of water per day helps promote uric acid excretion.
• Avoid High-Purine Foods: Reduce consumption of foods high in purines, such as meats, seafood, organ meats, and alcoholic beverages. Also, limit the intake of overly sweet foods and sugary drinks.
• Avoid Alcohol: Alcohol metabolism can impact uric acid excretion, leading to gout. Minimize alcohol consumption to reduce the risk of gout.
• Maintain Ideal Body Weight: Achieve and maintain a healthy weight. Gradual weight reduction, about 1 kg per month, is recommended for overweight individuals. However, weight reduction is not advisable during acute gout attacks. Additionally, reduce intake of high-calorie foods.