Gout is a disease developed due to deposition of uric acid in joints of body. Uric acid forms crystals and gets deposited between joints resulting in inflammation and severe pain. Uric acid is formed in body as a result of purine catabolism. Purines are present in all tissues of body and in many types of food materials. Usually, the uric acid gets dissolved in blood and reaches kidney, where it enters urine by filtration process. Gout develops when the level of uric acid increases in blood and forms crystals.
In more than 75 percent of patients, the primary symptom of gout is development of pain in joint of big toe. In majority of cases, swelling and pain also develops in heels, ankles, knees, fingers, wrists and elbows. Different stages of progression of gout are:
- Asymptomatic hyperuricemia: In this stage, there will not be any external symptoms to identify. The level of uric acid in blood will be high and can be identified by blood test. There is no need of treatment at this stage.
- Acute gouty arthritis: This is also known as acute gout. It is at this stage, uric acid crystals are formed in blood and get deposited in the joint between bones. This situation of hyperuricemia results in sudden and intense pain in joints, which are very tender and warm. The severe pain usually develops during night and can get triggered by drugs and alcohol. Initially the pain subsides with in 3-10 days even without treatment. In most of the cases, it will not develop with in some months or even years. But the pain will be so severe and prolonged in the next attack which resume may be years after.
- Intercritical or interval gout: this is the time period between first and second attack of gout. During this stage of most cases, the patient will not take care of diet and exercise. There will not be any symptoms or pain during this stage and remains normal.
- Chronic tophaceous gout: This stage is accompanied by severe pain and is the most disabling. This can result in permanent damage to kidney and joints.
Symptoms of Gout
The initial symptom of gout is increase of uric acid level in blood. This is known as hyperuricemia. It is followed by formation of uric acid crystals in blood and accumulation at joints. This results in inflammation and pain at more than one joint. This is accompanied by redness, heat, pain and stiffness. Later, the pain will spread to other joints also. |