Gout is one of the oldest disease known and also the most frequently recorded in medical history. It is an arthritis disease, where the acute condition is characterized by a sudden onset of severe pain in any of the joints. It is a form of arthritis where uric acid crystals form in your joints and cause intense pain.
The pain is usually recurrent and in 50% of the cases, the joint at the base of the big toe is affected. That is when the foot is referred to as gout foot or gout big toe and the gout is called podagra.
Other joints that can be affected are those of the fingers, wrists, elbows or knees.
The arthritis of gout is referred to as gouty arthritis. The affected joint becomes painful, swollen, red, tender and is hot to touch. The pain of gout tends to flare up suddenly without warning at night and can be so severe as to awaken you.
These two quotes by famous people give an indication of how severe the pain of gout can be.
“Be temperate in wine, in eating, girls, and sloth; Or the Gout will seize you and plague you both” — Benjamin Franklin.
“People wish their enemies dead, but I do not; I say give them the gout, give them the stone!”—- Mary Worley Montagu.
What Is Gout? Definition
Gout is a disorder of the purine metabolism and develops when uric acid crystals form deposits (tophi) in the joints, on tendons, and in the surrounding tissues.
Normally, the uric acid that is absorbed from the foods and dissolved in the blood, is excreted through the urine via the kidneys.
If too much uric acid is produced, or its excretion is impaired it can build up in the blood and form needle-like crystals that cause inflammation and pain in the joints and surrounding tissue.
High level of uric acid levels in the blood is called hyperuricemia.
Due to the high levels of uric acid in the blood, deposits of needle-like crystals of uric acid (sodium urate) get deposited in the connective tissue and the concerned joint spaces giving rise to gouty arthritis.
Besides the joint of the big toe, the other joints commonly affected are ankle joints and the metatarsal joints of the feet. In chronic gout, there are recurrent episodes of pain and inflammation, which may affect more than one joint.
Blood levels of uric acid
Uric acid is a chemical produced when your body breaks down and metabolizes foods that contain organic compounds called purines. Such foods, among others, include meat, poultry, and seafood
- The normal levels of uric acid in blood serum are between 3.0 to 7.0 mg per deciliter.
- The normal levels of uric acid in a 24-hour urine sample are 250 to 750 mg per deciliter.
- High level of serum uric acid is referred to as hyperuricemia.
Types of Gout
Gout is classified as primary and secondary.
1) Primary Gout
In primary gout, the cause of high uric acid levels is not known. It is associated with impaired excretion or overproduction of uric acid and is an inherent fault of purine metabolism. It is linked to dietary excesses, alcohol abuse, and metabolic syndrome.
2) Secondary Gout
In secondary gout, the cause of high uric acid levels is identified. Serum uric acid levels are increased due to the presence of an existing disease such as proliferative disease of the blood and bone marrow, lead poisoning or long-standing chronic renal failure on dialysis.
Gout facts and figures
- Men between the age of 40 to 50 years, postmenopausal women and people with renal impairment are the most affected.
- About 8 persons out of 1000 are affected by gout.
- Gout is 9 times more common in men than in women.
- According to The Centers for Disease Control and Prevention (CDC), 8.3 million Americans were affected by gout between 2007 to 2008.
- Gout accounts for 5% of all arthritis cases.
- Studies indicate that there has been an alarming rise in gout cases globally.
- Famous celebrities who had gout include King Henry VIII of England, Benjamin Franklin, and Thomas Jefferson.