Gout

By Dr Ananya Mandal, MD

Gout describes a type of arthritis that is characterized by the formation of sodium urate crystals in and around joints.

One of the main symptoms of gout is acute pain in the affected joint. This often occurs in the joint of the big toe, although any joint in the body may be affected. Other symptoms include redness, warmth and swelling in the joint area.

The symptoms usually develop rapidly and pain becomes the most intense within just 6 to 24 hours of onset. This is referred to as a “gout attack”. The symptoms can last for between three and ten days, after which point the joint starts to feel normal again and pain subsides. However, anyone who develops gout is likely to experience further attacks at a later stage.

Cause and pathology

Gout is caused by a build-up of uric acid in the blood. Uric acid is formed in the body as a breakdown product of purines and is usually excreted by the kidneys. If uric acid is produced in excess or if the excretion process is compromised, uric acid can accumulate to an abnormal level in the blood. Over several years, hard and needle-shaped sodium urate crystals then form.

These crystals may irritate the soft lining of the joint called the synovium, causing inflammation and joint pain. Some of the crystals may also clump together to form lumps referred to as “tophi”. These tophi can eventually cause irreversible damage to the joint cartilage and adjacent bone, leading to pain and stiffness whenever the joint is used.

Treatment

Treatment is aimed at reducing and alleviating symptoms of pain and inflammation as well as preventing future gout attacks. Non-steroidal anti-inflammatory drugs (NSAID) can be used to relieve inflammation and pain. Colchicine may also be used for this purpose. Sufferers can reduce their uric acid levels by taking the appropriate medication and making any recommended lifestyle changes such as losing weight.

Reviewed by , BSc

Further Reading

Last Updated: Jul 24, 2014

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