Gout is defined as a buildup of uric acid in the joints, causing pain and inflammation. Also sometimes called gouty arthritis, the disease develops over many years in stages of severe attacks alternating with periods of dormancy.
Stages
The disease gout passes successively through four stages as it develops, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. These are called asymptomatic hyperuricemia, acute gout, intercritical gout and chronic tophaceous gout. Asymptomatic hyperuricemia is the beginning of gout and often goes undetected until the first bout of acute gout. Intercritical gout is a dormant period between acute attacks. Chronic tophaceous gout is the final phase, when gout develops from an occasional problem to a long-lasting constant one.
Symptoms
Asymptomatic hyperuricemia generally has no outward symptoms, but slowly increasing levels of uric acid may be detected through a blood test. An episode of acute gout presents itself as extreme pain in a joint, accompanied by swelling, redness, warmth and stiffness of the affected joint. There may be an accompanying fever, and small lumps called tophi may appear under the skin. In intercritical gout, no symptoms are present. Chronic tophaceous gout occurs after the disease has caused years of damage and can include the same symptoms as acute gout that occur intermittently, as well as causing constant joint pain and deformities of the affected areas.
Timing
Gout may progress through the various stages over many years or even decades. According to Gout.com, asymptomatic hyperuricemia may last up to 20 years before symptoms develop. Most people have their first acute attack between the ages of 40 and 60, and the attack typically lasts a few days. The intercritical gout period may last 10 years or more, but it is more common for it to last from six months to two years. The final stage, chronic tophaceous gout, develops 10 years or more after the initial acute attack.
Prevention
Methods that prevent attacks of acute gout may also help prevent it from developing further into chronic gout. Dietary changes such as eliminating purines from the diet, drinking plenty of fluids and avoiding alcohol may keep attacks at bay and lengthen the time spent in intercritical gout. Preventive doses of medications such as nonsteroidal anti-inflammatory drugs may help some people keep gout from developing further.
Considerations
Most people who receive treatment for gout in the early stages of the disease don't go on to develop chronic tophaceous gout. Instead, if an individual can bring acute attacks of gout under control, he may find that the intercritical gout periods become longer.
