Patrick Hammer of London tells about his first attack of gout, which occurred when he was only 32-years-old and living in Somalia. 

“I woke suddenly in the night to an unbearable pain, as if someone had stamped on the ball of my foot. An area of my foot was shining red, like a snooker ball, and was very sensitive and inflamed. I was amazed. I didn't know what it was.”

"The nurse at the British Embassy looked at my foot and told me that I had gout. I was prescribed a medication called colchicine, which helped clear the uric acid from my blood.”

According to the Arthritis Foundation, gout is a form of inflammatory arthritis that causes sudden, severe pain, swelling and tenderness – most often in the large joint of the big toe.  Gout is not always limited to the big toe; it can affect other joints including the feet, ankles, knees, hands, wrists, elbows and sometimes soft tissue and tendons. It usually affects only one joint at a time, but it can become chronic and, over time, affect several joints.

A gout attack can last anywhere from a few days to two weeks, if untreated. The disease most commonly affects men and can manifest anywhere from age 30 onward. Women get gout too, although they are at a slightly lower risk, and it usually appears after menopause.

Dr. John McDougall writes that the most important cause of gout is an increase in the intake of rich foods, which are high in uric acid precursors, known as purines. Other lifestyle habits, like alcohol consumption are also believed to encourage the deposition of uric acid crystals in the joints.  

According to an article in the New England Journal of Medicine, “Higher levels of meat and seafood consumption are associated with an increased risk of gout… Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout.”

Many doctors emphasize the role of heredity as the cause of gout.  It can play a role because some people convert purines to uric acid faster than others and they eliminate uric acid from their bodies through their kidneys more slowly than others due to metabolic differences.

Slower excretion is more common in certain ethnic groups, such as Filipinos.  But, Filipinos can maintain low levels of uric acid when they follow their native diet consisting of generous portions of rice and vegetables.  If they switch to the high-protein, high-purine diets preferred in more affluent societies, their levels of uric acid rise quickly.

With a change in diet the uric acid level will decrease, as will the tendency to develop gout and kidney stones.