Gout Disease
Gout is a condition in which uric acid, a by-product of metabolism, rises above normal levels. Uric Acid is a naturally occurring substance produced in the chemical breakdown of the purine bases that compose the genetic material called DNA. As cells die and release DNA from their chromosomes, purines are converted into uric acid which is promptly excreted in the urine and, to a lesser degree, the intestinal tract. When a person has gout, the uric acid forms crystals which are deposited in the joints. These uric acid crystal deposits give rise to inflammation, in turn causing pain, swelling and redness. However, because many other arthritic conditions and some infections have the same symptoms, gouty arthritis should be confirmed by laboratory testing. Analysis of joint fluid removed with a needle is the most specific method. If uric acid crystals are seen when the fluid is examined under a special microscope, the diagnosis is confirmed. In most cases, gout is associated with a condition known as hyperuricemia. Hyperuricemia occurs when the blood contains raised levels of uric acid sustained over long periods. The kidneys process uric acid and excrete this through urine. When uric acid levels become raised, the kidneys are unable to eliminate uric acid efficiently. In some cases, the cause of gout is not linked to hyperuricemia but to kidney disease. Blood uric acid levels can arise when the kidney is not functioning properly. Whichever cause, the kidneys can become damaged when blood uric acid levels are raised over long periods.
The body unable to eliminate uric acid, deposits a hardened crystallised form of uric acid (tophi) usually in the joints and skin. Within the joints, deposits can be made in the joint fluid (synovial fluid) and joint lining (synovial lining).Common areas for these deposits are the ankles, feet and ball of the large toe. Less common areas of uric acid deposits include the ears and eyes. Tophi, areas of hardened uric acid, may also be seen under the skin around the fingers and toes.
"Hyperuricemia" is the medical term for high blood concentrations of uric acid. This can be caused by under-functioning kidneys, dehydration, hormonal diseases, alcohol, a diet high in purine foods (eg. meats, poultry, broths, gravy, anchovies, sardines, scallops, peas and beans - see diet & nutrition section) and low doses of aspirin. Attacks of gout are caused by the body's inflammatory reaction to intermittent precipitation of uric acid crystals into the joint(s). They normally follow many years of asymptomatic hyperuricemia
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