Gout is a type of arthritis that develops when uric acid crystals accumulate in the joint tissues, causing friction and inflammation inside the joints. Uric acid is a natural product found naturally in the body and excreted through the urine. Sometimes, though, the levels of uric acid can reach abnormally high levels - too high to be effectively excreted through urination. In these cases, the crystals build up inside the joints, causing gout. Gout is more common among people who:
Gout occurs in four stages that develop over time. During the very early stage of the disease, uric acid builds up in the blood, but levels typically are not enough to cause noticeable symptoms. During the second stage, swelling and pain begin to occur in the joints, often beginning first in smaller joints like the joints of the hands and wrists, ankles and feet, or the big toe. Pain and swelling can develop rapidly during this stage. The third stage typically is one of remission when symptoms appear to lessen or even resolve. The fourth stage is the most serious, causing permanent joint damage and even kidney damage. This fourth stage is called chronic tophaceous gout.
Most people who have gout can be treated with pain medications and nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce swelling inside the joints. Steroid medications can also be used when NSAIDs don’t provide adequate relief. Medications are also available to decrease uric acid production. Most people with gout will be advised to follow a special “gout diet” that limits foods high in a chemical called purine, which plays a major role in the formation of uric acid. Alcohol consumption should also be limited. Lifestyle changes like exercise and losing excess weight can also help by keeping joints mobile and decreasing stress on the joints. It’s also important to seek care at the first sign of symptoms so treatment can be initiated as early as possible to prevent permanent joint deformity.