Thursday, May 26, 2016

What is gout?

Gout is a form of inflammatory arthritis caused by a buildup of uric acid crystals in a joint that can cause sudden, severe episodes of pain, tenderness, redness, warmth and swelling. It most often affects the joint of the big toe but it can affect other joints as well. The Arthritis Foundation states that gout affects nearly 4% of Americans and is more common in men than women. Yet few people understand what gout is and what to do about it.

A man with his young grandson

The stages of gout

According to the Arthritis Foundation there are four stages of gout:

Stage One: Asymptomatic

There are no symptoms or pain in this stage, but blood uric acid levels are high and crystals are forming in the joint.

Stage Two: Acute 

A gout attack happens when something (often a night of drinking) causes uric acid levels to spike or jostles the crystals that have formed in a joint, triggering the attack. The resulting inflammation and pain usually strike at night and intensify over the next eight to 12 hours. The symptoms ease after a few days and likely go away in a week to 10 days. Some people never experience a second attack, but an estimated 60% of people who have a gout attack will have a second one within a year. Overall, 84% may have another attack within three years.

Stage Three: Interval 

Gout is rarely a continuous problem - rather it tends to happen in relatively short-lived, very painful attacks. Interval gout is the stage during the time between attacks where there is no pain but low-level inflammation can still cause joint damage. Lifestyle changes and other treatment options are important at this stage to prevent future attacks or damage.

Stage Four: Chronic 

Chronic gout develops in people whose uric acid levels remain high over a number of years. Attacks become more frequent and the pain may not go away.

What causes uric acid crystals to build-up?

Uric acid is created and released into the blood during the breakdown of a substance in food called purines. Normally, the uric acid is filtered out of the blood through the kidneys and passes out of the body through urine. Higher than normal levels of uric acid in the blood may be caused by kidney damage or disease, making it hard for the kidneys to clear the uric acid. However, sometimes the buildup is caused by increased production of uric acid. Common causes of increased production include:
  • Excess consumption of foods high in purines like steak, seafood, and organ meats
  • Consumption of foods that encourage high uric acid levels, such as alcohol or sugary drinks
  • Certain medications, such as diuretics, salicylate-containing medications (like aspirin), niacin, or levodopa
  • Medical conditions such as high blood pressure, hypothyroidism, Kelley-Seegmiller syndrome or Lesch-Nyhan syndrome

Middle-aged couple enjoying a bike rideWhen it’s time to see the doctor

Gout attacks are sudden, painful and can cause joint damage over time - even during the time between attacks - which can lead to a loss of mobility. If you experience the sudden onset of pain, tenderness, redness, warmth and swelling - particularly in your big toe - it is time to see the doctor. Once diagnosed with gout, it is important to regularly visit your doctor to learn proper management and treatment that can prevent your gout from becoming chronic. With regular medical visits and smart lifestyle changes, you can live an active life with gout.

Learn more about gout in this first-hand account of Living with Gout.

Early detection for better quality of life

Gout is a form of arthritis that often benefits from lifestyle changes. Your primary care physician can help you develop a plan that helps reduce the likelihood of future gout attacks.

Schedule an appointment today.

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