Gout / Pseudogout

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Gout is a common form of arthritis that can cause acute attacks of swollen, painful, joints. Gout is caused by a buildup of uric acid in the joints, which forms sharp crystals that cause pain. It often starts abruptly in a single joint, most commonly the big toe.


Gout is caused by tiny needle-like crystals that build up in the joints. The crystals are made of uric acid, a chemical your body makes when it breaks down certain foods. Normally the uric acid dissolves in the blood and passes out of your body when you urinate (pee). When uric acid builds up, it can form sharp crystals that cause sudden pain in a joint. They can also build up in the kidneys and lead to kidney stones, which can cause problems with urination.

Gout attacks come on suddenly. A first gout attack will usually get better within 10 days, even with no treatment. You may not have another for months. Over time, attacks can happen more often and last longer. Symptoms of a gout attack can include:

  • Severe joint pain, usually with redness and swelling. 
  • Pain, often occurring first in a single joint. Pain usually occurs first in the big toe. It can also affect joints in the feet, arms, and legs. Over time, attacks are more likely to affect more than one joint at a time.
  • Sudden joint pain during the night or early morning.
  • Sudden joint pain triggered by drinking alcohol, taking drugs, having stressful events, or having an illness.

Symptoms usually go away completely between attacks.

When to See a Doctor

See a healthcare provider if you think that you have had a gout attack - even if the pain has gone away, let your healthcare provider know about it. The uric acid that caused the pain may cause pain or damage to your joints in the future.


Gout usually develops after age 40 in men and after age 55 in women. By age 65, about 4 in every 100 people have it.

Risk factors for gout include:

  • Obesity
  • Overeating
  • Drinking a lot of alcohol or sugary drinks
  • Eating a lot of meat or seafood
  • Fasting
  • Taking water pills (diuretic medicines)
  • Having a family member who also has gout

Some health conditions can also increase risk for gout. These include:

  • Injury
  • High blood pressure
  • Chronic kidney disease

People with gout have a greater risk of getting kidney stones.

Diagnosis and Tests

To find out if gout is the cause of your pain, your healthcare provider will ask for details about your pain. Gout pain usually comes on suddenly, causes pain for several days, and then goes away. Your healthcare provider may take fluid from your painful joint and check for uric acid crystals. Or, they may test your blood for high levels of uric acid.


Getting treatment can reduce the pain of a gout attack and help prevent attacks in the future. Without treatment, gout can lead to severe joint damage.

Your healthcare provider may recommend medicines such as:

  • Non-steroidal anti-inflammatory medicines (NSAIDs) to reduce pain and swelling
  • Steroid anti-inflammatory medicines (corticosteroids) to reduce pain and swelling
  • Colchicine to help prevent gout attacks

Your healthcare provider may also recommend lifestyle changes such as:

  • Changes to what you eat and drink. These changes are usually recommended together with medicines. Your healthcare provider or dietitian may recommend:
    • Low-fat milk, cheese, and other dairy products 
    • Whole grains, brown rice, beans, and other complex carbohydrates
    • Limiting or avoiding alcohol
    • Coffee
  • Losing weight.


To help prevent gout attacks, you can:

  • Drink plenty of water and limit sweetened drinks.
  • Limit or avoid alcohol.
  • Limit the amount of meat you eat. Get protein from low-fat dairy products.
  • Maintain a healthy weight.