Description of Gout
Uric acid is a substance that normally forms when the body breaks down
waste products (called purines). Uric acid is usually dissolved in the blood and
passes through the kidneys into the urine. For people with gout,
the uric acid level in the blood is so high that uric acid crystals form and
deposit in joints and other tissues. This causes the joint lining to become
inflamed, resulting in sudden and severe attacks of pain, tenderness, redness
After several years, the crystals can build up in the joints and surrounding
tissues, forming large deposits, called tophi. Tophi look like lumps under the
skin and are often found in or near severely affected joints, on or near the
elbow, over the fingers and toes, and in the outer edge of the ear.
Another condition, called pseudogout, is caused by deposits of calcium-based
(instead of urate-based) crystals in the joints.
Causes and Risk Factors of Gout
In about 90 percent of all cases, gout
is prevalent in men older than 40 and in menopausal women. An
"episode" often occurs overnight, and within 12 to 24 hours, there is
severe pain and swelling in the affected joint. The episode usually lasts about
five to 10 days.
Although the exact cause is unknown, gout may be caused by:
- genetic defect in metabolism, which causes overproduction and retention of
- kidney impairment that prevents normal elimination of uric acid
- thiazide diuretic medications (water pills) used to treat high blood
pressure and heart failure
- diseases of the blood cells and blood-forming organs, certain cancers and psoriasis
- environmental factors, such as obesity,
alcohol abuse and a purine-rich diet.
An episode of gout can be triggered by:
- drinking too much alcohol
- eating too much of the wrong foods
- sudden, severe illness
- crash diets
- injury to a joint
Symptoms of Gout
generally occurs in four (4) stages (asymptomatic, acute, intercritical and
chronic) and has the following signs and symptoms:
Asymptomatic stage - urate levels rise in the blood, but produces no
Acute stage - symptoms usually lasting five to 10 days
- sudden attack of joint pain
- joints feel hot, tender and look dusty red or bruised
Intercritical stage - symptom-free intervals between gout episodes.
Most people have a second attack from six months to two years, while others are
symptom-free for five to 10 years.
- persistently painful joints with large urate deposits in the cartilage,
membranes between the bones, tendons and soft tissues
- skin over the deposits develop sores and release a white pus
- joint stiffness
- limited motion of affect joint
Diagnosis of Gout
The diagnosis of gout
is based on symptoms, blood tests showing high levels of uric acid, and the
finding of urate crystals in joint fluid. In chronic gout, x-rays show damage to
the cartilage and bones.