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What is gout?

Gout is an arthritic condition brought about by the build-up of urate crystals in the joint fluid (synovial fluid) that leads to joint erosion. The lining and surrounding tissues become inflamed, tender and painful, which are the typical symptoms of gout. The joints of the big toe, the knees and the hips are typically under attack.
Gouty arthritis is the medical term of the condition.


What causes build-up of urate crystals?

Urate crystals build up because of excess levels of uric acid, which in turn comes from excess consumption of purine-rich foods like anchovies, brains, gravies, kidneys, liver, sardines, and sweetbreads. The build-up could also be caused by defects in metabolism.


Why is purine important?

Dietary purine is important because it is an essential component in the chemical structure of all living organisms. In humans, purine – once broken down into uric acid – acts as an antioxidant. Antioxidants fight free radicals that promote aging; when there is enough of it floating in the system, old cells are replaced.

Uric acid also strengthens blood vessel linings. When blood vessels weaken, aneurysm – the swelling of blood vessels – is likely to develop and become fatal.


Who usually suffers from gout?

Not everybody who suffers from excessive uric acid (hyperuricemia) develops symptoms of gout. Only 10% of Americans who have hyperuricemia suffer from gouty arthritis.

The condition is 9 times more common in men than in women, and male adolescents are more prone to attacks. The condition peaks at age 75, whereas gout in women peak after menopause.


What are the symptoms of gout?

Like any arthritic condition, gout manifests in joint pain, except that the degree of pain is so severe it becomes crippling. The sudden onset of hot, red, swollen joints is the unmistakable manifestation of gout. In most cases, the joint under attack is the base of the big toe where swelling is coupled with tenderness. This condition is known as podagra.

Pain subsides one or two weeks after the first wave of attacks even if it is left untreated. Pain and swelling typically run their course, even as urate crystals continue to collect in the synovial fluid. Over time, crippling pain occurs in shorter intervals and for lengthy periods; attacks become more frequent and prolonged. Without proper diagnosis and treatment, gout can develop simultaneously in multiple joints.

It is important to note that joints can become eroded even if the pain seems to subside. Urate crystals continue to get deposited in between obvious flares.
In advanced cases, urate crystals lump around the joints of elbows, Achilles tendon, and even earlobes – a collection of deposits known as tophi. These are not painful, but these accumulations provide a clue in the diagnosis of gout.
What are the complications of gout?

Gout, by itself, is not deadly. However, if left untreated, the crystals could get deposited in the kidneys and the rest of the urinary tract. Once urate crystals block the body’s drainage system, complications can arise. Kidneys perform a host of functions, like removing excess water and salt in the body through urine, keeping blood pressure in check, and maintaining the balance of salts. The advanced symptoms of gout manifest in kidney problems. Once kidney stones are not removed, they can be fatal.


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