What is gout?
Gout develops when uric acid stays high in the blood for a long time (hyperuricemia), urate crystals build up in and around joints, and the immune system reacts with sudden, intense arthritis (Dalbeth et al., 2021). It's more common in men and after middle age, and the pain can be so bad that even a bedsheet hurts.
This article is general health information and is not a substitute for diagnosis or treatment. If symptoms persist, see a doctor.
What are the symptoms?
- A joint—most often the base of the big toe, or the top of the foot, ankle or knee—turns red, hot and swollen, often overnight
- Pain peaks within a day and settles in one to two weeks
- Without treatment, flares get more frequent and lumps called tophi can form under the skin
What triggers gout?
| Factor | Examples |
|---|---|
| Food and drink | Beer and other alcohol, organ meats, red meat, sugary drinks high in fructose |
| Health conditions | Obesity, high blood pressure, kidney disease, metabolic syndrome |
| Medications | Some diuretics |
Treatment
Flares are treated with colchicine, NSAIDs or steroids. For frequent flares, tophi or uric acid kidney stones, the American College of Rheumatology recommends daily urate-lowering therapy such as allopurinol, adjusted to keep uric acid below about 6 mg/dL—a "treat-to-target" approach (FitzGerald et al., 2020). Managing related conditions like high blood pressure and metabolic syndrome matters too.
FAQ
- Does high uric acid mean I have gout?
- Not necessarily. Many people with high uric acid never have a flare, and symptom-free hyperuricemia usually isn't treated with drugs right away.
- Can I stop my medication once the pain is gone?
- Urate-lowering drugs work only if you keep taking them between flares. Don't stop without talking to your doctor.
Sources reviewed: 2026-10-25
References
- Dalbeth, N., Gosling, A. L., Gaffo, A., & Abhishek, A. (2021). Gout. The Lancet, 397(10287), 1843–1855.
- FitzGerald, J. D., Dalbeth, N., Mikuls, T., et al. (2020). 2020 American College of Rheumatology guideline for the management of gout. Arthritis Care & Research, 72(6), 744–760.