Gout is one of the most painful forms of
arthritis. The term "arthritis" refers to more than 100 different rheumatic diseases that affect the joints, muscles, and bones, as well as other tissues and structures. Gout accounts for approximately 5 percent of all cases of arthritis.
The condition occurs in approximately 840 out of every 100,000 people. It is rare in children and young adults. Adult men, particularly those between the ages of 40 and 50, are more likely to develop it than women, who rarely develop the disorder before
menopause. People who have had an organ transplant are more susceptible to it.
Understanding Uric Acid and Hyperuricemia
Uric acid is a substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods. Normally, uric acid is dissolved in the blood and passed through the kidneys into the urine, where it is eliminated.
If the body increases its production of uric acid, or if the kidneys do not eliminate enough from the body, increased levels of uric acid build up in the blood. This condition is called hyperuricemia.
Hyperuricemia is not a disease and by itself is not dangerous. However, if excess uric acid crystals form as a result of hyperuricemia, gout can develop. This increased level of uric acid in the blood can also lead to:
- Deposits of uric acid (called tophi) that look like lumps under the skin around the joints and at the rim of the ear
- Kidney stones from uric acid crystals in the kidneys.
This condition is caused when the levels of uric acid become so high that sharp crystals form inside the joint. These urate crystals cause inflammation. This combination of urate crystals in the joint and inflammation results in the signs and symptoms of this illness.
While there is no one specific cause, a number of factors increase a person's chances of developing it.
Possible symptoms of this condition may include:
- Sudden onset of intense joint pain
- Swelling in the joints
- Extreme tenderness in the joint area
- Redness and heat at the joint
- Stiffness in the joint.
This condition may be difficult for healthcare providers to diagnose, because the symptoms may be vague, and they often mimic other conditions. Therefore, in order to make a definitive diagnosis, the healthcare provider will ask a number of questions; perform a physical exam, looking for signs and symptoms of gout; and recommend certain tests and procedures.
(Click Gout Diagnosis to learn more, including conditions that may share similar symptoms.)
There is no
cure for gout. However, people with the disease can take medications and make certain lifestyle changes in order to keep it under control. The goal of any of these prevention methods is to control uric acid in the blood -- keeping it below concentrations at which crystals can form. This can reduce both the discomfort caused by the symptoms of gout and long-term damage to the affected joints. Proper treatments can help prevent disability due to this condition.
(Click Gout Treatments for more information, including specific medicines that may be used. Click Gout Prevention for strategies that have been found to be helpful in preventing the disease.)
For people with gout, diet can play a role in causing an attack, because foods high in purines will increase the amount of uric acid the body makes. Therefore, the primary diet recommended for people with this condition is a low-purine diet. Also, eating more low-fat dairy products, which are low in purines, has been shown to decrease the chances of having an attack.
The four stages of gout are as follows:
- Asymptomatic hyperuricemia
- Acute gout (also known as acute gouty arthritis)
- Interval or intercritical gout
- Chronic tophaceous gout.
Pseudogout is sometimes confused with gout because it produces similar symptoms of inflammation. However, with pseudogout, the deposits are made up of
calcium phosphate crystals, not uric acid. Therefore, pseudogout is treated somewhat differently than gout.
