Understanding gout: A guide for patients
5/19/2025 by Jaclyn (Jackie) Houghton, P.A.-C.
Gout is a type of inflammatory arthritis that causes sudden, severe attacks of pain, swelling and redness in the joints. Most often, it affects the joint at the base of the big toe, but it can also affect other joints. While it can be extremely painful, gout is also manageable with proper treatment and lifestyle changes.
What is gout?
Gout is caused by a buildup of uric acid in the blood. When uric acid levels become too high, it can form sharp, needle-like crystals in the joints, leading to inflammation and pain.
Uric acid is a waste product usually removed by the kidneys through urine. It forms when your body breaks down substances called purines, which are found naturally in your body and certain foods.
Who gets gout?
Gout can affect anyone, but here are common risk factors:
- Increasing age is a risk factor for developing gout. The age of onset varies by sex; for males, the most significant increase in gout incidence occurs during the fourth or fifth decades of life, while in females, it occurs later in the sixth or seventh decades.
- People with a family history of gout.
- Individuals who are overweight or have certain health conditions, like high blood pressure, diabetes and kidney disease.
Common triggers and risk factors
Some common factors that can raise your risk of developing gout include:
- Diet: Eating a lot of red meat, seafood, or foods high in purines.
- Alcohol: Especially beer and spirits.
- Sugary drinks: Beverages sweetened with fructose.
- Certain medications: Diuretics (water pills), aspirin and some immune-suppressing drugs.
- Dehydration: Not drinking enough water can increase uric acid levels.
Symptoms of gout
A gout attack often happens suddenly, sometimes overnight. Symptoms include:
- Intense joint pain, most often in the big toe, but also ankles, knees, elbows, wrists and fingers.
- Swelling and redness.
- Warmth in the affected joint.
- Limited movement in the joint.
Attacks usually peak within 24 hours and can last a few days to a week.
Diagnosing gout
To diagnose gout, your clinician may:
- Review your medical history and symptoms.
- Examine the affected joint.
- Test your blood for uric acid levels.
- Take a sample of joint fluid to look for uric acid crystals.
Treatment options
Gout treatment focuses on relieving symptoms and preventing future attacks.
During an attack
- Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
- Colchicine, a medication that reduces gout inflammation.
- Corticosteroids, either pills or injections.
Long-term management
- Urate-lowering medications such as allopurinol or febuxostat.
- Regular check-ups to monitor uric acid levels.
- Lifestyle changes to reduce triggers.
Living with gout: Lifestyle tips
Managing your diet and lifestyle can make a big difference. Here are some tips:
- Stay hydrated and drink plenty of water.
- Limit purine-rich foods, such as red meat, organ meats and shellfish.
- Reduce alcohol and sugary drink intake.
- Eat more low-fat dairy, fruits and vegetables.
- Maintain a healthy weight.
- Exercise regularly but avoid stressing painful joints during a flare.
Takeaway
While gout can be very painful, it's manageable with the right approach. Understanding your triggers, following your treatment plan and making healthy lifestyle choices can help reduce flares and improve your quality of life. Always work closely with your healthcare clinician to tailor a plan that's right for you.
Jaclyn (Jackie) Houghton, P.A.-C., is a Community Internal Medicine, Geriatrics and Palliative Care physician assistant. She is interested in chronic disease management, and preventive and acute care.