Overview
Gout is a form of inflammatory arthritis caused by elevated levels of uric acid in the blood (hyperuricaemia), which can form sharp, needle-like crystals in a joint, causing sudden, severe episodes of pain, swelling, and tenderness. Gout most often affects the joint at the base of the big toe but can affect any joint. Attacks can last days to weeks, and gout can become chronic if not treated.
Causes and risk factors
The following factors are associated with the development of Gout:
- Elevated uric acid from overproduction or underexcretion
- Diet high in purines: red meat, organ meats, shellfish
- Excessive alcohol, particularly beer and spirits
- Sweetened drinks containing fructose
- Obesity
- High blood pressure and cardiovascular disease
- Kidney disease reducing uric acid excretion
- Certain medications: diuretics, aspirin, cyclosporin
- Family history
- Dehydration
Signs and symptoms
Common signs and symptoms of Gout include:
- Intense joint pain, usually in the big toe
- Pain typically beginning at night and very severe
- Joint appears red, swollen, warm, and tender
- Attack usually peaks within 24 hours
- Limited range of motion
- Lingering discomfort after acute attack resolves
- Tophi — deposits of urate crystals under skin in chronic gout
Diagnosis
Gout is typically diagnosed through a combination of medical history, physical examination, and appropriate investigations such as blood tests, imaging, or specialist review, depending on the specific condition and presentation. Your doctor will consider all relevant symptoms and risk factors before making a diagnosis.
Treatment options
Treatment approaches for Gout may include:
- During attack: NSAIDs (indomethacin, naproxen) as soon as possible
- Colchicine for acute attacks
- Corticosteroids if NSAIDs and colchicine contraindicated
- Ice applied to affected joint
- Urate-lowering therapy: allopurinol, febuxostat for prevention
- Dietary changes: reduce red meat, shellfish, alcohol
- Increase fluid intake
- Maintain healthy weight
Prevention
Maintain healthy weight, limit alcohol and purine-rich foods, stay hydrated, take urate-lowering therapy consistently if prescribed.
Complications
If left untreated or poorly managed, Gout can lead to complications including:
Recurrent acute attacks, chronic gouty arthritis, tophi formation, kidney stones, and joint damage.
Sources and references: This article is written in accordance with NHS UK, WHO, and Mayo Clinic clinical guidelines. It is reviewed for accuracy by the SymptomSense content team. ICD-10 code: M10. Last reviewed June 2026.