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Hello and welcome to HealthiNation. I'm Dr. Holly Atkinson.
It's a condition that has been known and treated since ancient Egypt. It was also once
called "the king of diseases and the disease of kings." But despite that regal description,
gout is really quite common. It is a type of inflammatory arthritis that affects an
increasing number of people, both men and women, worldwide. It is often brought on by
diet, but with dietary changes and medication, it is also one of the most controllable types
of arthritis.
In this video series, we'll take a look at what gout is, its symptoms and how it's
diagnosed. Finally, we'll look at ways to treat gout and to prevent it from reoccurring.
Gout is a debilitating condition that typically affects one joint, but can affect multiple
joints and other tissues in the body. It's caused by a build-up of uric acid, also called
urate, which crystallizes around the joints, triggering inflammation and pain. While a
person with gout has hyperuricemia—meaning high levels of uric acid in the blood--some
people with hyperuricemia might not develop gout. In fact, about two-thirds of those with
hyperuricemia never go on to develop gout.
Uric acid is produced in the body after purines, which are naturally found in some foods and
in human tissue, are broken down. Normally, uric acid is processed by the kidneys and
expelled in urine. If uric acid builds up in the blood, either due to underexcretion
or overproduction, it creates a condition called hyperuricemia. This excess of uric
acid can lead to it crystallizing around joints, particularly in the big toe, other joints
of the feet and the lower extremities. This crystallization causes the immune system to
react. When that happens, white blood cells attack the crystals, thereby causing inflammation,
redness, heat and pain in the afflicted areas.
There are four different stages of gout: - In the asymptomatic stage, a person has
hyperuricemia, or elevated levels of uric acid in the blood, but does not experience
the symptoms of gout. Tests can reveal, however, that crystals are forming, and tissue damage
is occurring.
-The second stage is acute gout, during which the classic symptoms of gout are present.
These include pain—typically severe pain--, swelling, redness and warmth in joints. The
symptoms are worst within several hours, and usually improve completely over a few days
to several weeks, even if not treated.
- The period between gout attacks is called the intercritical, or interval, stage. During
this stage, a person does not experience symptoms, however uric acid levels remain high and the
disease progression of crystal formation and its resulting damage continues.
- Chronic tophaceous gout is characterized by nodules, called tophi, which are formed
from collections of uric acid crystals, which can be found in joints, bones and cartilage.
Unfortunately, these nodules can cause bone deformities. This stage can take as many as
10 years to develop
People with gout are also at an increased risk of kidney stones. That's because uric
acid crystals can deposit in the kidneys or lower urinary tract. In fact, about one of
every six people who have gout develop kidneys stones due to uric acid crystals.
After the first flare-up of gout, subsequent flare-ups might not occur for several months
and might even take years to return. As time goes on, though, acute gout attacks will likely
become more frequent and can last longer. The longer someone has gout, the more likely
flare-ups will occur. So, it's important to get medical attention at the earliest signs
of gout, and stick with the regimen prescribed by your doctor.