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Gout is a form of arthritis caused by the accumulation of sodium urate crystals in the joints. In the UK, gout affects around 1 in 45 individuals, the majority of which are older people. Men are affected by the condition more often than women. This is because estrogen increases the renal excretion of uric acid.
The progression of gout is divided into the following four stages:
During this stage, the blood level of uric acid is raised but the patient does not present with symptoms. Treatment is not usually required at this stage.
By this stage, sodium urate crystals have been accumulating in the joints and formed deposits that cause pain, swelling and redness. The symptoms usually develop rapidly and pain becomes most intense within just 6 to 24 hours of onset. This is referred to as a “gout attack.” Symptoms can last for between three and ten days, after which point the joint starts to feel normal again and pain subsides.
An attack can be triggered by stressful events, alcohol consumption, diseases or medication. Attacks tend to be recurring and almost everyone who develops the condition experiences more attacks in the future. Another attack may not occur for months or even years but the condition should be monitored and a treatment plan maintained to prevent further attacks and joint damage.
This refers to the time period between gout attacks where the patient is free of symptoms and joint function appears to be normal. However, the uric acid crystals continue to deposit in the joints and accumulate quietly, which eventually leads to another attack unless the uric acid level is reduced to below 6.0 mg/dL.
This is the final stage of gout, which is a form of chronic arthritis characterized by permanent damage to the cartilage and bone in the joint. In the majority of cases, this stage of gout can be prevented if patients follow any treatment plans or lifestyle changes recommended to them by their GP.