Gout is a common type of inflammatory arthritis. It is more common in men and affects women mostly after menopause. Gout is caused due to build-up and deposition of uric acid crystals in the joints. Uric acid is a byproduct formed by metabolism of purines. Purines are chemical compounds present in many foods we eat. If excessive uric acid is formed or if it is not eliminated properly from the body, the level of uric acid increases in blood (hyperuricemia). When the level of uric acid rises in blood and becomes excessive (hyperuricemia), it can lead to formation of urate crystals around the joints. This causes inflammation and severe pain in cases with acute gout attack.
Expected duration of gout
First acute attack of gout in most cases subsides in 3–10 days. Treatment with medications (such as non-steroidal anti-inflammatory drugs, painkillers, colchicines and/or corticosteroids) can effectively control pain in acute gout attack within 12 to 48 hours. In untreated cases, symptoms of an acute gouty attack usually last for about a week and gradually subside during the following week or two. Only rarely does an acute attack last for weeks in some patients.
Most people after the first attack of gout remain without symptoms for a long period of time. Some eventually have recurrence of symptoms after a period of months or years. Treatment with uric acid-lowering drugs can suppress gout attacks and their recurrence and prevent long-term complications of the disease. There, however, are not many uric acid-lowering agents and in cases of medication, intolerance or ineffectiveness, the person is not left with many options.
If gout is not managed properly, it can become chronic or recurrent. People with chronic or recurrent gout can develop hard nodular masses of uric acid crystals (tophi) in different soft-tissue areas of the body. Tophi are formed when the person has substantial overload of uric acid within the body for a long period. They occur in about 50% of people after 10 years and 72% of people after 20 years if they are not treated. About 2% of patients not treated for gout develop severe debilitating arthritis typically 20 years after the first attack.
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