Gout

Gout is a form of arthritis caused by crystals that build up in your joints and cause joint swelling and pain. These crystals are caused by too much uric acid build-up in your blood. Your kidneys filter your body’s natural uric acid, but if levels get too high or the kidneys can’t remove enough of it, urate crystals can form and settle into a joint, causing sudden pain, swelling, and redness. Gout affects men more often than women. Foods or drinks rich in purines (red meat, sardines, anchovies, drinks with high-fructose corn syrup like soda), high alcohol intake, and drugs like diuretics (furosemide, etc.) can raise your risk of gout.

What Are the Signs/Symptoms?

Gout’s main symptoms are sudden onset, severe joint pain and swelling. Gout can affect one or more joints. Gout flares are typically followed by periods of no symptoms. Urate crystals can form tophi (swelling under your skin) which is often located over a joint or on the outer ear and can damage the joints over time. Diagnosis is based on history and physical exam, laboratory tests, imaging and sometimes evaluation of joint fluid where there is swelling. Blood tests can measure uric acid, although high levels don’t always mean you have gout. Diagnosis may require a sample of joint fluid using a needle to get fluid from the swollen joint to look for urate crystals under a microscope.

What Are Common Treatments?

Gout treatments include drugs to ease inflammation, lower uric acid in the blood, and/or help the kidneys remove excess uric acid. Colchicine (Colcrys) or Nonsteroidal anti-inflammatory drugs (NSAIDs) and Glucocorticoid (steroid) pills or shots into the joint can ease pain and swelling of an attack. Gout treatment aims for a uric acid level of 6 mg/dL or lower in the blood to dissolve or prevent crystals. Allopurinol (Zyloprim) and Febuxostat (Uloric) block uric acid production. Probenecid (Benemid) helps the kidneys remove uric acid, and pegloticase (Krystexxa) infusions help break down uric acid. Each person with gout needs a unique treatment plan including dietary and lifestyle modifications and medication.

Living with Gout

Diet and lifestyle modification can help control gout and prevent attacks so it’s important to watch your diet and maintain a healthy weight. Gout is often associated with high blood pressure, heart and kidney disease, so your primary care provider or rheumatologist may test and/or watch for signs of these health problems.

• Avoid shellfish, gravies, red meat, soups and organ meats such as liver
• Limit alcohol, especially beer
• Avoid drinks high in sugar or fructose like concentrated juices or sodas

Updated February 2025 by Pankti Reid, MD, MPH, and reviewed by the American College of Rheumatology Committee on Communications and Marketing.

This information is provided for general education only. Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition.