Gout is due to accumulation of what?

The body makes urate when it breaks down purines, substances found naturally in cells and in some foods. Normally, the kidneys remove urate through urine. When urate remains too high or is not cleared well, crystals can form. The immune system reacts to those crystals, causing a gout flare with heat, redness, swelling and marked joint pain. The big toe is a familiar site, but ankles, knees and other joints can also be affected. Chronic kidney disease and obesity can be associated with a higher gout risk, but symptoms alone cannot establish the cause of joint pain.

During a flare, rest the affected joint, raise it when practical and use a cool pack wrapped in cloth for short periods. Avoid pressure on the joint and drink fluids unless a clinician has told you to restrict them. A clinician may use your history, examination, blood tests and sometimes fluid testing to distinguish gout from other causes. Long-term treatment can lower urate and reduce future crystal formation; take it exactly as prescribed and do not start or stop medication without guidance.

Seek urgent medical assessment for a hot, swollen joint with fever, chills, feeling faint or rapidly worsening illness, because infection can look similar to gout. Arrange an appointment if this is your first sudden attack, if flares recur, or if pain is not settling. New knee or ankle swelling deserves assessment rather than being assumed to be gout.

Ask whether joint-fluid testing is needed, what may be raising your urate, whether kidney function affects treatment, and how to manage medicines during a flare.