Gout is a condition which is caused by high levels of uric acid in the blood, a condition known as hyperuricemia.
The high concentrations lead to the formation of needle-like urate crystals, which form when the uric acid level in the blood begins to exceed about 7mg/dl.
These crystals then travel in the blood stream and eventually accumulate in the joints.
It is the body’s reaction to these accumulations of uric acid crystals which cause painful gout attacks.
The best known symptoms of gout are swelling around the affected joint, severe pain and stiffness. But this is not the only way gout affects you.
There are several different main stages of gout: Asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout and chronic gout.
The first, asymptomatic hyperuricemia, is a period during which there are no external symptoms of gout. This is the period where the uric acid levels are high or are increasing.
Patients may have hyperuricemia for many years before external symptoms are seen. Many patients may never see the symptoms of gout.
Once gout progresses to the acute gout attack phase, the external symptoms of gout begin to appear.
The patient gets painful attacks around some joints and with the passage of time the painful attacks may become more frequent and more severe in intensity.
When hyperuricemia is not addressed, the gout proceeds to the next stage where gout attacks are triggered.
This is also known as acute gouty arthritis. During this stage the best-known symptoms of gout appear, including intense pain and swelling.
The pain and discomfort seems all out of proportion with the cause, and has been compared by some to having a dislocated joint. Even the slightest of movements or touches become unbearable.
This severe pain develops rapidly and will usually strike in the middle of the night. Sometimes the swelling may extend beyond the joint, and the pain radiate along the affected limb.
The skin may appear red and shiny, and be quite tight over the affected area. The skin may actually begin to peel as a result.
Other symptoms of gout that some people may experience are chills with mild fever. There is a stage of gout called intercritical gout. This is the period between gout attacks.
Unfortunately when you start getting gout it will often seem to go away for a period of time, but then will return again suddenly and without warning.
Between the gout attacks the patient will feel normal, but there remains an ongoing accumulation of uric acid crystals.
As gout gets worse, these intercritical periods get shorter, with the gout returning more frequently.
The attacks themselves also tend to get worse. If gout is not treated properly or the contributing lifestyle factors, such as diet, are not addressed, then the attacks become more and more frequent.
Eventually they can get so close together that the body does not have any chance to heal itself between attacks.
At this point the pain from gout is more or less permanent and the life of the sufferer is nothing short of misery.
As the opportunity for healing is reduced there is a much higher chance of permanent damage being done.
In extreme cases, the uric acid can group together so much that they form visible lumps underneath the skin.
These are known as tophi and can cause deformity and permanent damage.
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