Gout: How Do I Know I Have It?

                

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Gout is more prevalent in men who are older than forty, and women who are menopausal. A gout episode typically occurs during the night, and will be accompanied by severe pain and swelling of the affected joint, within twelve to twenty-four hours. These episodes can last upwards of five to ten days. The exact cause of Gout is unknown, but many doctors and scientists speculate that it could have to do with a genetic defect within the metabolism causing an overproduction and retention of uric acid, kidney impairment preventing normal elimination of uric acid, environmental factors like obesity, a purine-rich diet or alcohol abuse, diseases of the blood cells, certain cancers, or the use of water pills.

Episodes of gout are typically triggered by the consumption of too much alcohol, surgery, a sudden or severe illness, injury to a joint, chemotherapy, eating too many of the wrong foods, or surgery.

There are typically four stages that occur with Gout: The Asymptomatic Stage, Acute Stage, Intercritical Stage and the Chronic Stage. The Asymptomatic stage is marked by a rise in urate levels in the blood, but no symptoms are actually present at this time. The Acute stage is the stage where symptoms begin to appear, in the form of sudden attacks of joint pain, swelling, and a dusty or bruised appearance. The symptoms usually last between five and ten days. The Intercritical stage is marked by symptom free intervals wedged between episodes of Gout. It takes most people around six months to two years before they have another episode of gout, but there are others who remain symptom-free for up to ten years. The chronic stage is marked by persistently painful joints that develop large deposits of urate in the cartilage, joint stiffness and limited motion of the affected joint.

Doctors diagnose Gout based on the symptoms that are presented, as well as blood tests that show high levels of uric acid where there should not be, and the finding of urate crystals growing in joint fluid. There is damage to the cartilage and bones on the x-rays of people with chronic gout.

Approximately 75% of the first attacks occur in the big toe, but other joints including the ankle, heel, knee, instep, elbow, fingers and spine can also be affected.

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