Complications of Gout

Gout when properly treated rarely causes long-term or life-threatening health problems. An untreated and uncontrolled gout is entirely a different matter. It can make acute gout attacks recur frequently and severely. Being a metabolic disease, it can also worsen other metabolic diseases and can lead to life-threatening conditions. 

Pain and Incapacity

The first obvious complication of gout is severe pain during an acute attack. If left untreated, recurring gout can cause damage to bone and cartilage resulting in permanent joint deformities and eventually incapacity or loss of motion. The pain can be so severe that most gout sufferers describe it as nothing they’ve ever experienced before.

Tophi

Another complication of gout is the formation of hardened uric acid crystals in the joints called tophi. These are usually found in the joints of the hands, feet and even in the earlobes. They are not only unsightly but also disfiguring to the joints. In some cases tophi can even grow to the size of a golf ball. Tophaceous gout is the last stage in gout progression and usually the hardest to treat.

Kidney Stones and Kidney Disease

Uric acid, the cause of gout, is also a “raw material” of kidney stones. About 10 to 25% of people with gout develop uric acid kidney stones; the risk is even higher for those with untreated gout. Kidney stones are an inherent risk for gout sufferers particularly for those taking uric acid lowering drugs that can increase uric acid concentration in the kidneys. When kidneys stones become bigger they also cause pain when passed through the urinary bladder. They also cause pain to the flanks and loins as well as fever and chills when a urinary tract infection develops.

About 25% of people with high uric acid develops kidney disease or may already have a kidney disease. In most cases however, people are likely to have kidney disease that causes poor excretion of uric acid leading to its high concentration in the body.

Other Metabolic Diseases

There is no clear explanation as to why gout or high uric acid increases the risk of heart disease. In a study published in Arthritis and Rheumatism in August 2006, gout increased the risk for heart disease in men with no previous history of it. Gout is also commonly associated with diabetes, another metabolic disease. Obesity is a common risk for all metabolic diseases and in fact in the case of gout, high body mass index and hip to waist ratio increases the risk for gout in both men and women.

These complications of gout show the importance of treatment. Some may think that getting rid of the pain during an acute gout attack is treatment enough but it is far from it. Effective gout treatment does not only take care of the pain during attacks but also controls uric acid to a level considered safe, that is below 6mg/dL.