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Gout can be considered to be a form of rheumatic disease. It is also the most painful types of rheumatic disease. Gout is the result of excessive uric acid forming crystals in the joints. These crystals deposit will usually lead to inflammatory arthritis which will cause heat, pain, redness, stiffness, and swelling in the joints. Gout accounts for about 5% of all cases of arthritis reported by doctors.

Gout may sometimes be confused with pseudogout, which has similar observable symptoms. However, for cases of pseudogout, the deposits of calcium phosphate crystals cause swelling and pain at the joints.

Uric acid is form from the breakdown of purines, which is a naturally occurring chemical, found in all food. It is also a part of all human tissue.

Uric acid is normally dissolved in the blood and passed through the kidneys where it will later be eliminated in the urine. A condition call hyperuricemia occurs when the levels of uric acid builds up in the bloodstream. This could result from the body increasing its production of uric acid due to the excessive amount of purine or when the kidneys is not able to eliminate enough uric acid from the body.

Hyperuricemia may also result when a person eats too much food containing high purine content. Hyperuricemia by itself is not dangerous and cannot be considered a disease. However gout will develop when excess uric acid forms crystals as a result of hyperuricemia. These uric acid crystals build up in the joint spaces resulting inflammation. Deposits of excessive uric acid can appear as lumps under the skin around the joints and ear rim. On top of that, kidney stones might develop when these uric acid crystals collect in the kidney.

Who Is Likely To Develop Gout?

Gout occurs in approximately 275 out of every 100,000 people. Men have higher chances of developing gout as compared to women. Men aged 40 to 50 are found to be the majority gout victims. Women rarely develop gout before menopause. Gout affects men and women differently: Men tend to develop gout at an earlier age as compared to women. Alcohol is often associated with the development of gout in men. Gout is rare in children and young adults.

What Are The Stages of Gout?

Joints Affected:

About 75% of the people with gout will be affected in their big toe during the course of the disease. In most cases, gout will affect the joints in the big toe initially. Other parts of the body that might be affected include the heel, ankle, knee, instep, elbow, wrist and fingers.

Stages:

There are 4 stages in gout:

1. Asymptomatic hyperuricemia

In this stage of gout, a person will have elevated levels of uric acid in the blood but has no other observable symptoms. No treatment is required for a person in this stage of gout.

2. Acute gout/ acute gouty arthritis

In this stage, hyperuricemia would have caused deposit of uric acid crystals in the joint spaces. This would result in a sudden beginning of intense pain and swelling in the joints, which may also be very tender and warm. An acute gout attack will generally occur at night. Stressful events, alcohol or drugs, or the presence of another illness could trigger these gout attacks. At the beginning, gout attacks usually will subside within 3 to 10 days, even without any treatment, following which one might not experience any more attacks for the next few months or even years. However if nothing is done to reduce the uric levels in the body, these gout attacks can come more frequently and last longer.

3.Interval/ intercritical gout

This is the period between acute attacks. During this stage, a person does not have any symptoms of gout and is capable of functioning their joints normally.

4.Chronic tophaceous gout

With proper treatment, most people with gout should not progress to this stage. This is the most serious stage of gout and usually develops over a long period, such as 10 years without proper treatment. In this stage, the disease would have caused permanent damage to the affected joints and in some severe cases the kidneys might be damaged as well.

What Are The Risk Factors For Gout?

There are a number of risk factors that are related to the development of hyperuricemia and gout:

*Gender and age are related to the risk of developing gout; it is found to be more common in men than in women and more common in adults than in children.

*Ones genes may play a role in determining a person's risk of getting gout, since up to 18% of people with gout have a family history of the disease.

*In some people, gout could result from an enzyme defect that will interfere with the way the body breaks down purines, many of these people have a family history of gout.

*The risk of gout is increased when one is overweight. This is because excess uric acid is produced due to more tissue available for turnover or breakdown.

*Drinking too much alcohol can lead to hyperuricemia. Alcohol interferes with the removal of uric acid from the body.

*Eating too much food which are rich in purines can cause or aggravate gout

*Lead exposure in the environment can cause gout.

*There are people with higher levels of uric acid in their body due to certain medicines they are consuming or certain physical conditions