What is gout?
Gout is a type of arthritis that causes sudden, severe attacks of pain, redness, heat and swelling in a joint. It happens when there is too much uric acid in the blood, which can form tiny, needle-like crystals in and around a joint. These crystals trigger intense inflammation, producing the hallmark gout attack.
Gout most often affects the joint at the base of the big toe, but it can affect other joints such as the ankles, knees, fingers and wrists. Attacks often come on quickly, frequently at night, and the affected joint can be so tender that even the weight of a bedsheet is painful.
Symptoms
A gout attack is usually unmistakable and develops rapidly, often reaching its peak within hours. Symptoms include:
- •Sudden, severe pain in a joint — often the big toe
- •The joint becoming hot, red and swollen
- •Skin over the joint looking shiny and feeling tender
- •Extreme sensitivity, so even light touch hurts
- •Attacks that often start at night
Causes and risk factors
Gout is caused by high levels of uric acid, a waste product made when the body breaks down substances called purines. Normally uric acid dissolves in the blood and passes out in urine, but if too much is produced or too little removed, it can build up and form crystals. Several factors increase the risk:
- •Being male, or a woman after menopause
- •A family history of gout
- •Being overweight
- •A diet high in purines — such as red meat, offal and some seafood
- •Drinking alcohol, especially beer, and sugary drinks
- •Certain medical conditions, including high blood pressure and kidney disease
- •Some medications, such as certain diuretics
Treatment and prevention
During an attack, treatment focuses on relieving pain and inflammation, usually with anti-inflammatory medication prescribed by a doctor, rest, and keeping the joint cool and elevated. Attacks usually settle within a week or two, but treatment can shorten and ease them.
To prevent future attacks, especially if they are frequent, doctors may prescribe long-term medication that lowers uric acid levels. Lifestyle measures also help: maintaining a healthy weight, moderating alcohol and sugary drinks, staying well hydrated, and limiting very high-purine foods. With the right approach, gout can usually be well controlled and attacks made rare.
Gout diet: what to eat and avoid
Diet has a meaningful influence on gout, because the uric acid that causes it is produced when the body breaks down substances called purines, some of which come from food. While diet is not the only factor and dietary changes alone may not fully control gout, sensible eating can help reduce attacks alongside any prescribed medication.
Foods high in purines can raise uric acid and are best limited. These include red meat, organ meats such as liver and kidney, and certain seafood including anchovies, sardines, mussels and scallops. Alcohol, particularly beer, and drinks and foods high in fructose, such as sugary sodas, also raise uric acid and are worth moderating. Staying well hydrated with water helps the body flush out uric acid.
On the positive side, some foods may help. Low-fat dairy products, plenty of vegetables (including those once thought problematic, which are now considered fine), whole grains, and cherries have been associated with lower gout risk in studies. Maintaining a healthy weight is also important, as excess weight raises uric acid, though crash dieting should be avoided as rapid weight loss can temporarily trigger attacks.
Long-term gout and joint health
While a single gout attack is intensely painful but temporary, gout that is left unmanaged over years can cause lasting problems, which is why long-term control matters. Repeated attacks in the same joint can gradually damage it, and persistently high uric acid can lead to the formation of hard deposits of urate crystals under the skin, called tophi, often around joints, the hands or the ears.
Long-standing, poorly controlled gout can also contribute to chronic joint pain and, in some cases, the development of kidney stones, as uric acid can crystallise in the kidneys. These complications are largely preventable with effective treatment that keeps uric acid levels low over the long term, which is why doctors may recommend ongoing uric-acid-lowering medication for people with frequent attacks or established complications.
The encouraging message is that with consistent treatment and sensible lifestyle measures, gout can usually be controlled well enough to prevent both attacks and long-term damage. People with gout are also often advised to have their blood pressure, kidney function and cardiovascular risk reviewed, as gout is associated with these conditions and managing them together supports overall health.
How gout differs from other joint problems
Gout is one of several conditions that cause joint pain, and distinguishing it from others helps ensure the right treatment, since approaches differ considerably. Gout is a form of inflammatory arthritis caused specifically by uric acid crystals, and its hallmark is sudden, intense attacks — often starting overnight in the big toe — with the joint becoming red, hot, swollen and extremely tender.
This pattern differs from osteoarthritis, the common wear-and-tear arthritis, which typically causes more gradual, persistent joint pain and stiffness rather than sudden severe attacks. It also differs from rheumatoid arthritis, an autoimmune condition that usually affects multiple joints symmetrically with prolonged morning stiffness. A condition called pseudogout can closely mimic gout but is caused by a different type of crystal.
Because these conditions are treated differently, an accurate diagnosis matters. Doctors diagnose gout from the typical pattern of symptoms, blood tests for uric acid, and sometimes by examining fluid from the affected joint under a microscope to confirm the presence of urate crystals. If you have joint pain and are unsure of the cause, a proper assessment ensures you receive the most effective treatment.