Also known as metabolic arthritis, gout is caused when a person’s metabolism weakens, resulting in excess uric acid that it is unable to excrete normally or efficiently. This harmful uric acid is deposited into the human joints and after some time forms uric acid crystals and causes a gout flare-up.

This disease is most often seen in middle aged males. In beginning stages, the pain doesn’t last long and usually disappear by itself in a few days. However, this is only the beginning of the agony.

Gout has 4 stages in total – hyperuricemia(asymptomatic gout), early stage(acute gout), mid stage(inter-critical gout) and late stage(chronic tophaceous gout). In the earlier stage, there are no clinical symptoms of gout besides a high blood uric acid value. As such, most patients are unaware of or choose to ignore even found this symptoms. After that, the pain will begin to attack the patient’s joints, usually starting at the big toe which starts to swell painfully along with redness, warmth and tenderness. The piercing knife-like pain is so strong that makes the patient always has sleepless nights.

At the mid stage, also known as inter-critical gout, the pain will spread to the fingers, toes, wrist, ankle, knee and other parts of the body. Then, the surrounding soft tissue and bone will also be affected with varying degrees of damage and dysfunction. As the crystallization continues to build up, it slowly forms stone-like structures called “tophi”.  At this point, the kidney’s performance will begin to deteriorate.

In the end, tophi will increase continuously to the point that it can easily rupture out of the crystals, resulting in serious deformity and dysfunction of the patient’s joints. This can severely affect the patient’s daily life as they will be in constant pain. In addition, the urate constantly deposited into the kidney which will eventually turn into kidney stones, causing problems like edema, oliguria, proteinuria, nocturia, high blood pressure, anemia and more. The kidneys will be damaged and begin to deteriorate, leading to kidney failure which can be life threatening for the patient.

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