Gout is considered a form of arthritis. The cause is an inherited fault in the way the body handles certain chemical substances. Uric acid is one of the by-products produced in the body in the digestion of food. In most persons this uric acid is readily eliminated by the kidneys. But in a person with tendency to gout the uric acid is not eliminated as quickly as it should be, and so the body’s fluids contain more or this substance than normal. Because this excess is best detected by measuring the amount contained in the blood plasma, this condition is called hyperuricemia (excess of uric acid in the blood).

According to www.rheumatology.org, an estimated 31.9 million (20.1 percent) U.S. adults have hyperuricemia. More specifically, they also noted hyperuricemia among 16.1 million men and 15.8 million women. They also found that the prevalence of hyperuricemia increased with age – with those participants ages 20 to 29 years being at a lower prevalence than those who are 80 years or older. Moreover, the study determined that prevalence of hyperuricemia among U.S. adults age 65 and older to be 8.4 million, or 31.3 percent of the population.

Many persons with hyperuricemia have no symptoms and do not know that they have this condition. But in a few of this group (about three persons per 1000 population) complications develop: (1) acute gouty arthritis, involving the joints; (2) tophaceous gout, in which hard masses of uric acid crystals develop in various parts of the body, often in relation to the joints; (3) development of kidney stones composed of uric acid crystals; and (4) gouty kidney disease in which the kidneys no longer function efficiently. Note the following additional facts on these four complications:

1. Acute gouty arthritis occurs in attacks which come unannounced and, if untreated, each runs a course of one or two weeks. The pain in such attack is severe and, if it is the first attack, usually emanates from just one joint. Often the joint at the base of the big toe is first affected. The joint becomes swollen, warm to the touch, and extremely tender. The skin over the joint is tense, shiny and red. Usually a series of attacks will occur, each more severe and more frequent. The ankle may be infected, the instep, the knee, and joints of the hands and arms.
2. Tophaceous gout is a chronic condition in which deposits of uric acid crystals, called tophi, make their appearance in various tissues. One of the favorite sites for tophus is the ear lobe. Commonly, however, tophi are situated in the vicinity of joints. The body’s tissues react to these tophi as to foreign bodies with mild but persistent inflammation. When untreated, there develops a certain destruction of the bones and other tissues adjacent to a tophus.
3. Kidney stones are more likely to develop in persons with high concentration of uric acid in blood.
4. Gouty kidney disease. There appears to be a two-way relationship between degenerative disease of the kidney and gout. About one third of the cases of hyperuricemia seem to be aggravated by or even caused by the inability of the kidneys to eliminate uric acid as readily as they should. On the other hand, the condition of hyperuricemia seems to damage the kidneys.

WHAT TO DO

1. If hyperuricemia is discovered before any complications of gout develop, the person should follow a program which lowers the concentration of uric acid in his body. Eliminate flesh foods and animal fats from the diet, as these contain substances that favor the production of uric acid.
2. If the person is overweight, the weight should be brought within “normal” limits.
3. Drink up to three quarts of water per day. This aids the kidneys in eliminating uric acid.
4. Hyperuricemia and gout require the care of a physician. Within recent years several medicines have been successfully used. It is now possible to relieve cases of acute gouty arthritis and to prevent its complications. Medicines are available which influence the metabolism of the uric acid, including colchicine, probenecid (Benemid), and allopurinol. These can make the difference between invalidism and a life essentially free from disability and deformity.

This information was taken from the New Illustrated Medical and Health Encyclopedia.