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Gout - What it is

Gout is the most common type of inflammatory arthritis. It is caused by an excessive amount of uric acid in the body. Gout often causes excruciating pain and swelling in the affected joints, particularly the big toe. If left untreated, the joints may be damaged resulting in deformity and restricted mobility even after an acute attack has subsided.

Uric acid is a natural substance in your blood and is filtered by the kidneys. If the uric acid level is too high, urate crystals can form in the joints. This can cause pain and swelling in the joints.

Patients with gout do not suffer from continuous pain all the time. They experience sudden onset of joint pain and swelling during the “acute attacks”. When the acute attacks subside, they may feel well for months or even years, but the attacks may recur and become more frequent.

From a medical point of view, there are 4 stages of gout:

  • Asymptomatic phase - Patients have elevated levels of uric acid in the blood, but do not experience any pain or swelling. Not all patients with high uric acid will have an acute attack
  • Acute gout - At this stage, uric acid crystals are deposited around the joint, causing sudden swelling and intense pain. This is commonly referred to as a gout attack.
  • “Interval” gout - In between gout attacks, patients may not experience any symptoms. The uric acid level remains high.
  • Chronic gout - If treatment is not sought, recurrent gout flares can cause damage to the affected joints, leading to joint deformity, chronic pain, and restricted mobility.

Most people with gout have their first attack between the ages of 30 to 40. The majority are men, although women may develop the condition after menopause. This is because the female hormone known as oestrogen can help to excrete uric acid from the body. Other diseases such as diabetes, hypertension, leukaemia, kidney disorders and certain medications can also cause gout.

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