What causes gout?

The body makes uric acid when it breaks down purines, and the kidneys normally remove it through urine. Gout can develop when the body produces more urate than it clears, or when clearance is reduced. Chronic Kidney Disease can limit removal. Obesity, inherited tendencies, dehydration, alcohol, certain medicines, and frequent intake of purine-rich foods may also contribute. A flare often causes sudden severe pain, warmth, swelling, and tenderness in one joint, commonly the big toe, but other joints can be involved.

Gout is diagnosed using the symptom pattern, examination, and sometimes joint fluid or blood testing. A painful swollen joint can have other causes, including infection, so it should not be self-diagnosed.

During a flare, rest the joint, keep it elevated when possible, and avoid pressure from footwear or bedding. Drink fluids unless a clinician has advised fluid restriction. Ask a clinician promptly about treatment, especially if you have kidney disease or take medicines that affect urate. Long-term management may include a urate-lowering plan and review of contributing medicines, food patterns, alcohol, and body weight; changes should be individualized rather than abrupt.

Seek urgent assessment for a hot, swollen joint with fever, feeling very unwell, rapidly spreading redness, or a first severe attack, because infection needs to be considered. Arrange follow-up for repeated flares, persistent swelling, hard lumps near joints, or reduced movement. A clinician can confirm the diagnosis and help prevent crystal buildup over time.

Ask how the diagnosis will be confirmed, whether your kidney function or medicines affect urate, what to use during a flare, and whether prevention treatment is appropriate.