Gout is a chronic, whole-body condition that typically occurs in cycles. Gout is a form of arthritis that affects joints and can cause pain and swelling in the affected joints, most commonly the big toe, ankle, knee and fingers. While these joints are most affected, the condition can occur in any joint.
Understanding what leads to pain and inflammation is your first step to understanding gout.
The pain and inflammation of Gout are due to a buildup of uric acid. When uric acid rises above a normal level in your body, the small molecules of uric acid can stick together, which forms crystals. These crystals most commonly form around the joints (such as the big toe) because this is where the blood vessels are the smallest. Additionally, these uric acid crystals form most easily in areas of the body that have a lower temperature, typically areas furthest from the heart and other organs. This is why the big toe and ankle are the most commonly affected areas for gout flares.
Purines are chemical compounds made up of nitrogen and carbon; they are produced naturally in our bodies but are also contained in the foods that we eat. We metabolize purines during digestion which creates the byproduct known as uric acid.
In people that do not have gout, the uric acid is reabsorbed and processed out of the body via their urine. When these uric acid levels rise too much, the body cannot keep up with the reabsorption and elimination process, which causes uric acid levels in our blood to rise; this condition is called Hyperuricemia. Individuals are considered to have Hyperuricemia if their uric acid blood level is 7 mg/dL or above.
Gout symptoms, as with other types of arthritis, are most often experienced in cycles that we refer to as “attacks” or “flares.” These flares may last anywhere from a few days to several weeks, depending on the individual. Trigger foods can cause flares even a few hours after consumption. They may also happen overnight or after an injury.
Commonly, one joint is affected by a gout flare, but it can still affect multiple joints at a time. It is not unheard of for a flare to begin in one joint and move to another over time.
If you are experiencing symptoms of gout, there are a variety of tests that your rheumatologist may decide to use to diagnose you and rule out any other potential diagnoses.
