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All About Gout – Symptoms, Diagnosis, Treatment

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How a Gout Flare-Up Develops

Gout results from a build-up of uric acid crystals (monosodium urate crystals) in a joint. These needle-like, microscopic crystals collect in the soft tissue of a joint, causing pain that can be excruciating, as well as swelling, redness, and warmth.

How uric acid crystals form

The build-up of uric acid crystals begins with purines, a chemical compound found in many foods.

  • When the body metabolizes purines, it produces a substance called uric acid.
  • The uric acid enters the bloodstream.
  • The kidneys filter the blood and normally filter out excess uric acid. This uric acid is then excreted via urine (70%) or stool (30%).
  • If the kidneys cannot adequately filter out excess uric acid, or if the body produces too much uric acid, there will be too much uric acid in the bloodstream.
  • Too much uric acid in the bloodstream is called hyperuricemia.
  • In some people, hyperuricemia leads to the formation of uric acid crystals that collect in joint tissue, leading to painful symptoms.

An inability to adequately process and excrete uric acid accounts for an estimated 90% of gout cases. Other cases occur because a body produces too much uric acid.

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