<P> Gout is due to persistently elevated levels of uric acid in the blood . This occurs due to a combination of diet and genetic factors . At high levels, uric acid crystallizes and the crystals deposit in joints, tendons, and surrounding tissues, resulting in an attack of gout . Gout occurs more commonly in those who regularly eat meat or seafood, drink beer, or are overweight . Diagnosis of gout may be confirmed by the presence of crystals in the joint fluid or in a deposit outside the joint . Blood uric acid levels may be normal during an attack . </P> <P> Treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, or colchicine improves symptoms . Once the acute attack subsides, levels of uric acid can be lowered via lifestyle changes and in those with frequent attacks, allopurinol or probenecid provides long - term prevention . Taking vitamin C and eating a diet high in low - fat dairy products may be preventive . </P> <P> Gout affects about 1 to 2% of the Western population at some point in their lives . It has become more common in recent decades . This is believed to be due to increasing risk factors in the population, such as metabolic syndrome, longer life expectancy, and changes in diet . Older males are most commonly affected . Gout was historically known as "the disease of kings" or "rich man's disease". It has been recognized at least since the time of the ancient Egyptians . </P> <P> Gout can present in multiple ways, although the most usual is a recurrent attack of acute inflammatory arthritis (a red, tender, hot, swollen joint). The metatarsal - phalangeal joint at the base of the big toe is affected most often, accounting for half of cases . Other joints, such as the heels, knees, wrists, and fingers, may also be affected . Joint pain usually begins over 2--4 hours and during the night . This is mainly due to lower body temperature . Other symptoms may rarely occur along with the joint pain, including fatigue and a high fever . </P>

Why is gout called the rich mans disease