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The Four Stages of Gout Progression

November 19, 2012 by Mayank.

The Centers for Disease Control and Prevention report that, in America alone, there are more than 6 million adults suffering from gout. What is gout? Gout is a form of arthritis that is caused by the buildup of uric acid (hyperuricemia) in the joints of the ankles, feet, hands, knees, and wrists, but especially the big toe.

This condition is extremely sudden in its onset and quite difficult to diagnose since the symptoms aren't very definitive. In fact, for a positive confirmation of gout, doctors are required to draw synovial fluid from the inflamed joint and examine it for the presence of uric acid crystals. While severely painful, gout is not just controllable, but also treatable. However, if ignored, it can progress through the four stages of this condition, before finally ending up as a chronic problem.

Stage One (Asymptomatic Hyperuricemia)

Ironically, stage one of gout - asymptomatic hyperuricemia - is characterized by the lack of any visible symptoms whatsoever. Even though the body has elevated levels of uric acid in the blood, there will be no pain or discomfort to draw a person's attention to the vulnerable position he is in. For this reason, those that have a history of gout in the family must take preventative measures by adopting a healthier diet and lifestyle and drinking one to two liters of water every day.

Stage Two (Acute Gouty Arthritis)

As the condition progresses to this stage, hyperuricemia would have lead to the formation of crystals in the joints. As a result, they swell up and become warm and tender to the touch. This is followed by an attack of intense pain, usually at night, which can be triggered by alcohol or drugs, another illness, or even stressful events.

The attack is at its worst in the first 24 hours, although there is residual discomfort that can last anywhere from three to ten days. Subsequent episodes may occur after several months, even years. However, as time passes, these attacks become not just more intense but more frequent and last longer as well.

Stage Three (Interval or Inter-critical Gout)

Inter-critical gout is the period between gout attacks, when the pain has subsided completely. The patient experiences no discomfort and is able to use his joints normally and comfortably. At this stage, doctors recommend exercises and diet modification as a means to prevent a recurrence of the episode.

Stage Four (Chronic Tophaceous Gout)

Chronic tophaceous gout is the final and most debilitating stage of this condition. Even though it takes a long time to develop (almost as much as 10 years sometimes), by this time, the joints would have sustained permanent damage and the patient would be extremely vulnerable to kidney stones as well.

In addition to chronic pain this stage also sees the presence of tophi - hard nodular uric acid crystals deposited in and around joints. Needless to say, this is a very painful stage, but one that can be avoided if the patient takes preventive measures and receives proper treatment.

In the end, it is essential to remember that, if allowed to progress unchecked, gout can become almost unbearable. At the same time, proper diet, lifestyle changes, regular health checkups and timely treatment such as Colchicine for gout can help regain control of one's life.


Filed under: Stages of Gout.

Tags: stages of gout, gout progression, uric acid, hyperuricemia, gouty arthritis, inter-critical gout, chronic tophaceous gout, colchicine for gout.


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