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What is Chronic Gout?
Chronic gout is a recurrent form of arthritis that is caused by a buildup of uric acid crystals in the fluid around the joints. These crystals can irritate the cartilage and cause inflammation in the joint. Patients suffering from chronic gout may first experience acute attacks of pain, swelling, and restricted movement. After several untreated acute episodes of gout, the condition can become chronic.
Uric acid is a metabolic breakdown product of purines, the nitrogen-containing bases that are found the nucleic acids DNA and RNA. At the time of cell death, purines are released from cell nuclei and uric acid is formed. Excess purine may be present after DNA or RNA synthesis and this purine is also broken down into uric acid. Molecules such as adenosine-5’-triphosphate (ATP) and guanosine-5’-triphosphate (GTP) that transport energy to cells contain purine as well.
Purines are also ingested as part of the diet. They are found in high concentrations in animal-based foods such as liver, brains, herring, and sardines. Some plant-based foods, such as oatmeal and mushrooms, also contain purines.
Patients suffering from chronic gout usually have several outbreaks of acute gout with each outbreak followed by a period of remission. As this condition progresses, the periods between episodes get shorter and shorter. Chronic gout can either develop because the patient produces too much uric acid or because the patient is unable to excrete enough uric acid from the body.
Symptoms of chronic gout can appear in any joint but most commonly occur in the first joint of the big toe. Diagnosis is made by taking a patient history of symptoms and outbreaks. A blood test may be done that can measure uric acid levels. To confirm the diagnosis, fluid can also be extracted from the joint and examined for crystals under a microscope.
During a gout attack, the patient should rest the joint, drink fluids, and eat a diet high in fruits and vegetables. Anti-inflammatory medications may relieve pain during the outbreak. A medication called colchicine may help reduce inflammation by interfering with the ability of immune cells to ingest the uric acid crystals.
Long-term treatment should focus on reducing uric acid levels in the blood and preventing any future attacks of gout. The medication allopurinol may be prescribed because it inhibits the enzyme that converts purine to uric acid. Following a diet high in fruits and vegetables and low in purines may help relieve symptoms of chronic gout.
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![Full fat dairy products can exacerbate gout.]()
Full fat dairy products can exacerbate gout. -
![Uric acid is involved in the development of gout.]()
By: Alila Medical MediaUric acid is involved in the development of gout. -
![Some high fat meats and dairy products raise uric acid levels.]()
By: Elena SchweitzerSome high fat meats and dairy products raise uric acid levels. -
![Sardines, as a source of purines, can cause gout.]()
By: Picture PartnersSardines, as a source of purines, can cause gout. -
![Overweight individuals have an increased risk of developing gout.]()
By: DaveOverweight individuals have an increased risk of developing gout.
Discussion Comments
@Iluviaporos - I read recently that coffee is another really good way to help reduce your chances of getting gout. But basically, the best home remedies for gout are to eat well (lots of healthy foods) and exercise and get plenty of sleep.
@Mor - Well, gout does have a genetic basis so I hope you aren't fond of the same kinds of foods. It's actually becoming more common now, because people are eating the sort of thing that causes it more frequently.
But most of the time it's quite controllable if you try to eat a lot of fruit and vegetables and lay off the rich foods.
There's a character in the Game of Thrones books who has severe gout and he basically never gets up from his wheelchair because his feet and legs are completely misshapen and he's in constant pain. It makes me want to jump inside the books and feed him blueberries and vegetables.
My dad used to get gout all the time and it was so painful for him. He would basically not be able to walk and he would flinch if anyone even went near his feet.
To some extent it was his own fault, because he really loved rich meats that are associated with developing gout, like sweetmeats and kidneys and liver.
But it always seemed like the punishment of having that kind of pain was much worse than the crime! And he never took gout pain relief either, which was something I couldn't understand. I know if I ever develop it, I will be straight to the doctor to get some pain meds.
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