Stages of Gout Progression

Gout is a known chronic, progressive disease that can worsen over time. Its long list of complications include, joint damage, ugly and disabling hardened uric acid crystal deposits in the joints of the hands, feet, elbows and ears and uric acid kidney stone formations. It can start early and can take anyone by surprise when an acute, very painful attack happens.

Studies reveal that a lot of people can have elevated uric acid levels in their blood for long periods of time without ever experiencing a gout attack. In some cases, a person can have high uric acid for 20 years before the onset of the first acute gout attack. This only shows that while high uric acid levels is a precursor to gout attacks, it could take considerable time before gout manifests. Once a person suffers an acute gout attack, there is no turning back. If not kept under control, gout can recur and advance to more severe and more frequent attacks. Here is how gout can progress over time:

The Different Stages of Gout Progression

Stage One: Asymptomatic Hyperuricemia

A person can have elevated uric acid without having gout flares. This is the asymptomatic stage of gout. Treatments to lower uric acid at this stage are not recommended as it is still considered harmless at this stage. However if a person has the classic indicators of hyperuricemia progressing into gout such as obesity and poor eating habits then he should consider modifications in his diet and lifestyle to lower his uric acid to healthier levels.

Stage Two: Acute Gout

This is the stage when the first attack is triggered. This is when something made your hyperuricemia progress to uric acid crystallizing in your joints causing pain and swelling. Each attack is termed acute gout or gout flare. In this stage you will be prescribed medication for pain control. You will most likely be recommended to take medication to lower your uric acid once the pain has subsided.

Stage Three: Intercritical Gout

This is the time in between gout flares when you are not experiencing any pain. You still have gout during this time. In fact, uric acid crystals may still be present in your joints and may still cause damage. It is then important for uric acid to be monitored and kept at below 6mg/dL even when not experiencing acute gout attacks.

Stage Four: Chronic Tophaceous Gout

This is the final stage and the most incapacitating one. Frequent attacks may leave over time hardened uric acid crystal deposits called “tophi”. They get deposited in joints of the hands, feet and elbows, even behind the ears. They cause constant joint discomfort, inflammation and damage. They also cause ugly joint deformities.

In addition to formation of “tophi”, chronic gout may also risk kidney stone formations and eventually kidney damage.