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 symptoms such as 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 it 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 the touch. The pain 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 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 foods and dissolved in the blood, is excreted through the urine via the kidneys.
A high level of uric acid 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 in the foot that are commonly affected are the ankle joints and the metatarsal joints of the feet. In chronic cases, 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 organic compounds called purines. Purines can be endogenous or exogenous.
Endogenous purines are produced by the body itself and found in the body cells. About 2/3 of purines in the body are endogenous.
Exogenous purines are purines that enter our bodies from the foods that we eat.treatment of kidney stones
Our body metabolizes foods and drinks that contain organic compounds called purines. Foods with a high content of purines include meat, liver, poultry, anchovies, mackerel, dried beans and peas, and beer.
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.
A high level of serum uric acid is referred to as hyperuricemia. High levels of uric acid can be a sign of gout or kidney stones. If untreated, high uric acid levels may eventually lead to permanent bone, joint, and tissue damage, kidney disease, and heart disease.
Types of Gout
Gout is classified as primary and secondary.
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.
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.
