Gout Health Center

Gout is a condition that occurs when uric acid, a waste product produced during metabolism, is deposited as needle-like crystals into the joints and soft tissues in the body. Once inside the joints, the uric acid crystals cause inflammatory arthritis, which leads to swelling, redness, heat, stiffness and pain in and around the joints.

Uric acid is a substance created from the breakdown of purines, a component of human tissue found in a variety of foods. Usually, uric acid becomes dissolved in the bloodstream and is passed through the kidneys into the urine. However, if there is an increase in the production of uric acid or if the kidneys do not eliminate enough of the uric acid from the body, it begins to build up in the blood, resulting in a condition known as hyperuricemia.

Hyperuricemia may be brought on by eating high-purine foods, which include liver, dried beans, peas, anchovies and gravies. By itself, hyperuricemia is not dangerous. But if uric acid crystals build up from the excess of purines caused by hyperuricemia, gout can develop.

Gout often starts in the joints in the big toe. Other points where gout commonly begins include insteps, ankles, heels, knees, wrists, fingers and elbows. Chalky deposits of uric acid can start to appear as lumps under the skin around the joints and the rim of the ear. These deposits also can collect in the kidneys and can cause kidney stones.

Gout can progress through four main stages: Asymptomatic hyperuricemia, acute gout or acute gouty arthritis, interval or intercritical gout and chronic tophaceous gout.

Asymptomatic hyperuricemia is the initial stage of the condition when the patient has elevated levels of uric acid in the bloodstream but no other symptoms. Acute gout, or acute gouty arthritis, occurs when the crystallized uric acid seeps into the joints causing sudden onset of intense pain and swelling in the joints.

Interval or intercritical gout is the symptomless period in between acute attacks of pain. Chronic tophaceous gout is the most debilitating stage of the condition, developing over a long period of time. During this time, the disease can cause permanent damage to joints and even the kidneys. With prompt treatment, patients with gout typically do not reach this stage.