1.What is gout? Gout is the name our ancestors gave us, which is very good, realistic and lifelike. As the name implies, gout consists of the words “pain” and “wind”, which includes two meanings: (1) pain comes and goes quickly, without a trace, without a shadow; (2) pain is intense: when the wind blows, it hurts like hell. 2. Is gout a problem with internal organs? On the surface, gout has joint pain, it is a problem with the joints, but in fact, it is a problem with the internal organs, the liver and kidneys, why do you say so? The culprit of gout is the combination of genetic factors and eating too well, which leads to high uric acid in the body, which is deposited in the joints and causes joint pain. And where does uric acid come from? There are endogenous and exogenous sources of uric acid, and since we are mainly talking about diet, we will focus on exogenous sources here. The meat we usually eat contains a lot of nucleic acid, which is converted into purine in the intestine, which is circulated through the blood to the liver, where it is converted into uric acid, which is excreted through the kidneys and intestines. If there is a problem with the liver and kidneys, the enzyme that metabolizes purine into uric acid in the liver is abnormal, and too much uric acid is produced, and the kidneys cannot excrete it in time, then there is too much uric acid in the body, isn’t there? For example, like the water in the pipe, the upstream water is constantly flowing, and the faucet is blocked, the water is not stagnant in the pipe. 3. Since there is a problem with the internal organs, but the manifestation is joint pain, which department should I go to? Many patients think that when they suddenly have joint pain and redness, they think they have broken their feet or have a local infection, so they go to surgery, and some primary care surgeons have difficulty in diagnosing it, so they use a lot of antibiotics to treat it. In fact, gout is a cool non-infectious inflammatory disease that resembles an infection and does not need to be treated with antibiotics. If you have joint pain, you should see the rheumatology and immunology department. If you do not have pain in the early stage, you can also see the endocrinology department, and in the late stage, if you have uremia, you should see the nephrology or urology department to see if you want to replace your kidney. 4. Why is it not a problem with the joints? It is not that there is no problem with the joints, here we have to distinguish the primary and secondary problems, the symptoms and the root problem. The most fundamental cause of gout attack is too much uric acid in the body. The joints are neither the place where uric acid is produced nor the place where it is excreted, but only the place where it is deposited. Like the plumbing mentioned earlier, the joints are neither the source of the water nor the faucet, but the “plumbing” in the middle. Why is it easy to deposit in the joints? The main reason is that the joints have a lot of movement, more movement will produce lactic acid, making the local acidic environment, in this acidic environment, the solubility of uric acid is low, so it will precipitate out. 5.Does high uric acid value mean gout? Gout and high uric acid cannot be equated, that is to say, high uric acid does not necessarily lead to a diagnosis of gout; neither can gout be ruled out even if uric acid is not high. Why? Because: (1) Some patients with high blood uric acid who are asymptomatic do not have gout attacks even after many years of follow-up, but of course these people have a less obvious uric acid level, or sometimes high and sometimes normal. (2) There are some gout patients who do not have high uric acid in laboratory tests for the following reasons: the laboratory tests are for total uric acid, including bound and free type, and if the total uric acid is normal, but the free type of uric acid in it is increased, it can also trigger gout; the level of uric acid itself is fluctuating; there are too many influencing factors, various foods and drugs, exercise, etc. all affect the value of uric acid; the body secretes adrenocorticotropic hormones internally during pain attacks, which can promote uric acid excretion without increase.