Gout
Gout is a form of inflammatory arthritis caused by a build-up of uric acid crystals in the joints, causing sudden attacks of severe pain, swelling, and redness — most commonly in the big toe. Attacks can be debilitating but are very effectively treated, and long-term medication can prevent recurrence entirely.
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This page provides general health information only and is not a substitute for professional medical advice.
What is gout?
Gout occurs when uric acid — a breakdown product of purines found in many foods — accumulates in the blood to a level where it crystallises and deposits in joints, causing intense inflammatory attacks. The most commonly affected joint is the metatarsophalangeal joint of the big toe, though gout can affect the ankles, knees, wrists, and fingers.
Untreated or recurrent gout can lead to chronic joint damage, deposits of urate crystals under the skin (tophi), and kidney stones. Long-term uric acid-lowering therapy is highly effective at preventing all of these complications.
Symptoms
- Sudden onset of intense joint pain — often beginning at night and reaching maximum severity within 12–24 hours
- Swelling, redness, and warmth over the affected joint
- The skin over the joint may appear shiny and feel extremely tender to even light touch
- Attacks typically last 3–10 days and then resolve completely
- In chronic gout: tophi (firm lumps of urate crystals) under the skin near joints
Causes & triggers
- High-purine foods — red meat, organ meats, shellfish, and oily fish
- Alcohol — particularly beer and spirits, which both increase uric acid production and reduce excretion
- Sugary drinks and fructose-rich foods
- Dehydration — reduces uric acid excretion by the kidneys
- Diuretic medications — thiazides and loop diuretics reduce uric acid clearance
- Kidney disease — impaired uric acid excretion
- Genetics — family history significantly increases risk
- Obesity and metabolic syndrome
When to see a doctor
See a doctor at the first suspected gout attack for diagnosis confirmation and prompt treatment. Anyone experiencing two or more attacks per year should discuss long-term uric acid-lowering therapy, which is highly effective at preventing recurrence and protecting joints and kidneys.
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Treatment options
Acute attack
- NSAIDs (e.g. naproxen, indomethacin) — first-line treatment for acute gout attacks
- Colchicine — highly effective for acute attacks, particularly when started early
- Corticosteroids — for patients who cannot tolerate NSAIDs or colchicine
Long-term prevention
- Allopurinol — the most widely used uric acid-lowering medication, taken daily
- Febuxostat — an alternative for patients intolerant of allopurinol
- Dietary modifications — reducing purine-rich foods, alcohol, and sugary drinks
- Maintaining good hydration — at least 2 litres of water daily
How eMedClinic can help
Our doctors diagnose and treat acute gout attacks, order uric acid blood tests, and prescribe long-term preventative therapy. We also review medications that may be contributing to gout and provide personalised dietary guidance to reduce the frequency of attacks.
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