Gout is a disease caused by the formation of crystals of a salt of uric acid (sodium urate) in the tissues, most commonly in the joints.
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It is caused by the prolonged presence of a high level of uric acid in the blood (known as “hyperuricaemia”), in the same way that common salt deposits form in salt pans. When they grow and can be seen or touched under the skin, they are known as tophi.
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A true diagnosis of gout is made by confirming the presence of these crystals in the tissues. Hyperuricaemia is almost always caused by reduced elimination of uric acid by the kidneys or intestine. A number of factors can contribute to this: genetic predisposition, hormonal factors, diseases, medications and unhealthy diets.
Urate crystals produce an inflammatory response that can produce sudden symptoms (gout attack) of intense pain and swelling or go unnoticed (chronic asymptomatic inflammation).
Gout attacks affect the joints, but can also affect tendons and bursae surrounding the joints. They are a warning of the presence of urate crystals in the tissues and the need to seek medical attention.
Maintaining a balanced diet is very important.
Treatment consists of reducing uric acid levels in the blood, so that the urate crystals dissolve permanently; this requires an optimal uric acid level over a prolonged period of time. Prevention and treatment of pain is good for patients, but does not address the disorder that causes gout.
Gout is considered a “curable” disease: achieving an adequate blood uric acid level gradually dissolves the crystals, makes the symptoms disappear and prevents irreparable damage to the joints in the long term.
It is important for patients and healthcare professionals to consider the desirability of accurate diagnosis and early and appropriate treatment of gout.
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