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Quick Facts

Gout

By The Manual's Editorial Staff,

What is gout?

If you have gout, your body makes too much uric acid. Uric acid forms normally as your body breaks down old cells and makes new cells. In gout, the uric acid forms into crystals that sometimes deposit in or around your joints. The crystals cause severe joint pain, redness, and swelling.

  • Gout comes in sudden attacks that usually affect only one joint

  • The attacks go away in a few days

  • Some people have several attacks a year

  • If you have a lot of attacks, your joints may be damaged and may hurt all the time

  • Gout is more common in men than in women

  • Gout usually happens during middle age, but younger people sometimes get gout

  • To see if you have gout, doctors may use a needle to take fluid from your joint for tests

  • Doctors treat gout attacks with medicine to lessen pain and swelling

  • If you have frequent attacks, you may need medicine to help prevent them

What causes gout?

Gout is caused by high levels of uric acid in your blood. Very high levels of uric acid can form microscopic crystals that build up in your joints or under your skin (tophi). The buildup of crystals causes swelling and pain and may lead to joint damage.

You’re more likely to get gout if you:

  • Have a close relative with gout—gout runs in families

  • Have kidney problems, such as kidney disease

  • Drink a lot of alcohol

  • Eat a lot of certain foods that increase uric acid levels—such as liver, kidney, herring, mussels, sardines, asparagus, and mushrooms

  • Take certain medicines

  • Have lead poisoning (when lead builds up in your body)

  • Are overweight or obese

  • Have metabolic syndrome (a condition that can cause a large waist, high blood pressure, and high blood sugar levels)

  • Are having chemotherapy or radiation treatment for cancer

If you have gout, then an injury, sickness, or having surgery can trigger attacks.

What are the symptoms of gout?

Usually, you'll have sudden, severe pain in your joint.

Your joint becomes:

  • Warm

  • Red

  • Swollen

You may also have other symptoms such as:

  • Fever

  • Feeling sick

Your first attack usually affects only the big toe. Other joints may also be affected at times, such as:

  • Joints in your foot other than the big toe

  • Ankle

  • Knee

  • Wrist

  • Elbow

Even without treatment, your symptoms will slowly go away and you won’t have them again until your next gout attack.

Treatment will help the symptoms go away quicker. Treatment may also help prevent more severe attacks that affect more than one joint and that last up to 3 weeks.

Over time, you may have joint stiffness or joint damage. Hard lumps (tophi) can form under the skin around your joints. Certain medicines can help prevent the lumps or treat them.

About 1 in 5 people with gout also get kidney stones, which cause pain and kidney problems.

How can doctors tell if I have gout?

Doctors suspect gout based on your symptoms and an exam.

To tell for sure, doctors will do tests, such as:

  • Taking a small amount of fluid from your joint (joint aspiration)—doctors will look at the fluid under a special microscope to see if it has uric acid crystals

  • An x-ray of your joint to look for bone changes that are common in gout

  • An ultrasound to look for uric acid crystals inside your joint

Doctors may also do a blood test to check the level of uric acid. But your level may not be high even though you have gout.

How do doctors treat gout?

Doctors may:

  • Give you pills to lessen your pain and swelling

  • Rarely, inject medicine into your joint

  • Have you use a splint

  • Have you rest your joint, and apply ice to your joint for 20 minutes every few hours

  • If you're at risk or have uric acid kidney stones, tell you to drink 3 liters or more of fluids each day—about 12 8-ounce glasses of water

If you have uric acid stones in your urinary tract, doctors will use sound waves to break up the stones so you can pass them in your urine.

If you have large lumps (tophi) around your joints that don't disappear with treatment, doctors may do surgery to take them out.

How can I prevent gout attacks?

To prevent future gout attacks, doctors will tell you to:

  • Not drink alcohol

  • Lose weight

  • Stop taking medicine that raises levels of uric acid

  • Eat less foods that raise levels of uric acid

Sometimes, doctors will have you take medicine daily to lower the level of uric acid in your blood.