An arthritic condition that occurs when uric acid crystals accumulate in the joints is gout, which is called also crystal-induced arthritis. Usually is affected the large joint of the big toe, but can be affected also other joints like the knee, ankle, foot, hand, wrist and elbow. Rarely is affected the shoulders, hips or spine. It's better to know that gout does not spread from joint to joint.

The substance that normally forms when the body breaks down waste products called purines is uric acid, which usually is dissolved in the blood and passes through the kidney into the urine. The acid uric level in the blood at people with gout is very high that uric acid crystals form and deposit in joints and other tissues. From this point of view the joint lining becomes inflamed which causes severe attacks of pain, tenderness, redness and warmth.

After several years, tophi which are large deposits can be formed by the building of crystals in the joints and surrounding tissues. Tophi is like a lumps under the skin and can be found in or near severely affected joints, on or near the elbow, over the fingers and toes, and in the outer edge of the ear. Pseudogout is caused by deposits of calcium-based crystals in the joints.

The most cases of gout are meeting to men older than 40 and women in menopausal. Often an "episode" characterized by a severe pain and swelling in the affected joint occurs overnight and within 12 to 24 hours. Usually this episode lasts about five to 10 days.

Unfortunately the exact cause is unknown, but there are some causes like: genetic defect in metabolism which causes overproduction and retention of uric acid, kidney impairment that prevents normal elimination of uric acid, thiazide diuretic medications used to treat high blood pressure and heart failure, diseases of the blood cells and blood-forming organs, certain cancers and psoriasis, and environmental factors like obesity, alcohol abuse and a purine-rich diet.

An episode of gout can be triggered by: drinking too much alcohol, eating too much of the wrong foods, surgery, sudden, severe illness, crash diet, injury to a joint and chemotherapy. Generally gout presents the following stages: asymtomatic, acute, intercritical and chronic. In the case of asymtomatic stage the urate levels in the blood is high, but there are no symptoms. Usually the symptoms in acute stage last 5 to 10 days and those are: sudden attack of joint pain, swelling, joints feel hot, tender and look dusty red or bruised.

The symptom-free intervals between gout episodes is met in intercritical stage. In most of the cases the second attack appears from 6 months to 2 years, and others are symptom-free for 5 to 10 years. In chronic stage are present the followings: persistently painful joints with large urate deposits in the cartilage, membranes between the bones, tendons and soft tissues, skin over the deposits develop sores and release a white pus, joint stiffness and limited motion of affect joint.

The symptoms, blood tests which show high level of uric acid and the finding of urate crystals in joint fluid are necessary to diagnose gout. X-ray show damage to the cartilage and bones in the chronic gout. Unfortunately the gout cannot be curried, but with a proper diet, a healthy lifestyle and medications the symptoms of gout can be relieved and further episodes eliminated. Foods high in purine must be avoided or restricted: sardines, anchovies, brains, liver, kidneys, tripe, sweetbreads, tongue, shellfish, scallops, peas, beans and an excessive amount of red meat.

Daily must be consumed 10 to 12 eight-ounce glasses of non-alcoholic. For a healthy lifestyle is necessary to reduce alcohol consumption and lose weight. Because the treatment needs to be tailored for each person and may need to be changed from time to time can be complicated using medications for gout. May be prescribed by the doctor nonsteroidal anti-inflammatory drugs, colchicine, corticosteroid drugs, or adrenocorticotropic hormone to relieve the pain and swelling of an acute attack.

Colchicine, probenecid (Benemid, Parbenem or Probalan), sulfinpyrazone (Anturane) or allopurinol (Lopurin, Zurinol or Zyloprim) are recommended by the doctor to prevent future attacks. Probenecid, sulfinpyrazone and allopurinol are recommended to prevent or treat tophi. The patients need to understand why they are taking these drugs which are powerful, what side effects may occur and what to do if they have problems with the medication. For avoid risk factors the following facts must be considered: if the patient is overweight he needs a supervised weight-loss program with exercise, keep a purine rich diet, avoiding alcohol consumption, binge drinking.

People with gout should pay attention to what kind of treatment they take and especially at what they eat.If any side effects appear a doctor must be consult.