Gout
Gout is a form of arthritis caused by crystals of uric acid forming in a joint. Uric acid builds up when the body makes too much or the kidneys remove too little. Attacks come on suddenly, often overnight, with severe pain, redness and swelling, most commonly in the big toe but also in the ankle, knee or wrist. Gout is more common in men and is linked to alcohol (especially beer), red and organ meat, sugary drinks, obesity, high blood pressure, kidney disease and some water tablets. It is very treatable.
Find a Rheumatology SpecialistMedically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Symptoms
- Sudden, severe joint pain, often starting at night
- A hot, red, swollen joint, most often the big toe
- A joint so tender that even a bedsheet hurts
- Attacks that settle within one to two weeks, then return
- Hard lumps under the skin of the ears, fingers or elbows (tophi) in long-standing gout
When to See a Doctor
See a doctor during your first attack, so the diagnosis can be confirmed and other causes ruled out. See a doctor the same day for a hot, swollen joint with fever or feeling unwell, which can be a joint infection that needs urgent treatment. See a physician or rheumatologist if you have two or more attacks a year, tophi, kidney stones or kidney disease, as you are likely to need long-term treatment.
Treatment options
- Anti-inflammatory painkillers, colchicine or steroids to treat an attack
- Rest, ice and raising the joint during an attack
- Allopurinol or febuxostat, taken long-term, to lower uric acid and prevent attacks
- Regular uric acid blood tests to reach a target level
- Cutting down on alcohol, especially beer and spirits, and on organ meat and sugary drinks
- Reviewing blood pressure tablets that raise uric acid
Common Questions
Should I stop allopurinol during an attack?
If you are already taking it, keep taking it. Starting it is usually delayed until an attack has settled, and your doctor may add colchicine for the first few months to prevent flares.
Can diet alone cure gout?
Diet changes help, but for most people with repeated attacks they are not enough on their own. Medicine that lowers uric acid is what prevents attacks and joint damage in the long term.
Is gout a rich man's disease?
No. It earned that name because of its link with meat and alcohol, but anyone can get it, including people with kidney disease, high blood pressure, or on certain medicines.
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