In modern life, there're too much people have to against with modern problems. One of it is GOUT - very easy to meet in developing countries. So, let's talk about GOUT .
Gout (also known as podagra when it involves the big toe is a medical condition usually characterized by recurrent attacks of acute inflammatory arthritis—a red, tender, hot, swollen joint. The metatarsal-phalangeal joint at the base of the big toe is the most common affected, in around half of all cases. However, it may also present as tophi, kidney stones, or urate nephropathy. It is caused by elevated levels of uric acid in the blood which crystallize and are deposited in joints, tendons, and surrounding tissues.
Diagnosis is confirmed clinically by the visualization of the characteristic crystals in joint fluid. Treatment with non-steroidal anti-inflammatory drugs (NSAIDs), steroids, or colchicine improves symptoms. Once the acute attack has subsided, levels of uric acid are usually lowered via lifestyle changes, and in those with frequent attacks allopurinol or probenicid provide long-term prevention.
Affecting around 1–2% of the Western population at some point in their lives, gout has increased in frequency in recent decades. This is believed to be due to increasing risk factors in the population such as metabolic syndrome, longer life expectancy, and changes in diet. Gout was historically known as "the disease of kings" or "rich man's disease".
Signs and symptoms
Gout can present in a number of ways, although the most usual is a recurrent attack of acute inflammatory arthritis (a red, tender, hot, swollen joint).The metatarsal-phalangeal joint at the base of the big toe is affected most often, accounting for half of cases.Other joints such as the heels, knees, wrists and fingers may also be affected. Joint pain usually begins over 2–4 hours and during the night. The reason for onset at night is due to the lower body temperature during this time. Other symptoms that may occur along with the joint pain include fatigue and a high fever.
Long-standing elevated uric acid levels (hyperuricemia) may result in other symptomatology including hard, non-painful deposits of uric acid crystal known as tophi. Extensive tophi may lead to chronic arthritis due to bone erosion. Elevated levels of uric acid may also lead to crystals precipitating in the kidneys resulting in stone formation. This may result in urate nephropathy.
What Causes Gout?
Gout results from the deposit of needle-like uric acid crystals in the connective tissue, the joint space between two bones, or both. Uric acid is the end-product caused by the breakdown of purines. Purines are naturally found in the body and are found in many foods. It is excess uric acid in the body which causes the formation of uric acid crystals. Excess uric acid (hyperuricemia) in the body can be caused by:
- An increase in production of uric acid by the body
- Under-elimination of uric acid by the kidneys
- Increased intake of foods high in purines
The Stages of Gout
Gout can progress through four stages according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS):
- Asymptomatic gout - There is elevated uric acid levels in the blood but no other symptoms. Typically, at this stage no treatment is required.
- Acute gouty arthritis - Hyperuricemia causes deposit of uric acid crystals in the joint spaces. The intense symptoms of pain and inflammation are experienced. Early, acute attacks usually subside within 3-10 days even without treatment.
- Interval gout - The period between acute gout attacks when there are no symptoms and there is normal joint function.
- Chronic tophaceous gout - The most disabling stage of gout which occurs after many years, associated with permanent damage to the affected joints and sometimes the kidneys.
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