Gout is a common and complex form of arthritis that can affect anyone. It’s characterized by sudden, severe attacks of pain, swelling, redness and tenderness in one or more joints, most often in the big toe.

An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the bedsheet on it may seem intolerable.

Gout symptoms may come and go, but there are ways to manage symptoms and prevent flares.

The signs and symptoms of gout almost always occur suddenly, and often at night. They include:

When to see a doctor

If you experience sudden, intense pain in a joint, call your doctor. Gout that goes untreated can lead to worsening pain and joint damage. Seek medical care immediately if you have a fever and a joint is hot and inflamed, which can be a sign of infection.

Gout occurs when urate crystals accumulate in your joint, causing the inflammation and intense pain of a gout attack. Urate crystals can form when you have high levels of uric acid in your blood. Your body produces uric acid when it breaks down purines — substances that are found naturally in your body.

Purines are also found in certain foods, including red meat and organ meats, such as liver. Purine-rich seafood includes anchovies, sardines, mussels, scallops, trout and tuna. Alcoholic beverages, especially beer, and drinks sweetened with fruit sugar (fructose) promote higher levels of uric acid.

Normally, uric acid dissolves in your blood and passes through your kidneys into your urine. But sometimes either your body produces too much uric acid or your kidneys excrete too little uric acid. When this happens, uric acid can build up, forming sharp, needlelike urate crystals in a joint or surrounding tissue that cause pain, inflammation and swelling.

You’re more likely to develop gout if you have high levels of uric acid in your body. Factors that increase the uric acid level in your body include:

People with gout can develop more-severe conditions, such as:

Doctors usually diagnose gout based on your symptoms and the appearance of the affected joint. Tests to help diagnose gout may include:

Gout medications are available in two types and focus on two different problems. The first type helps reduce the inflammation and pain associated with gout attacks. The second type works to prevent gout complications by lowering the amount of uric acid in your blood.

Which type of medication is right for you depends on the frequency and severity of your symptoms, along with any other health problems you may have.

Medications to treat gout attacks

Drugs used to treat gout flares and prevent future attacks include:

Medications to prevent gout complications

If you experience several gout attacks each year, or if your gout attacks are less frequent but particularly painful, your doctor may recommend medication to reduce your risk of gout-related complications. If you already have evidence of damage from gout on joint X-rays, or you have tophi, chronic kidney disease or kidney stones, medications to lower your body’s level of uric acid may be recommended.

Medications are often the most effective way to treat gout attacks and prevent recurrent symptom flares. However, lifestyle choices also are important, and you may want to:

Make an appointment with your doctor if you have symptoms that are common to gout. After an initial examination, your doctor may refer you to a specialist in the diagnosis and treatment of arthritis and other inflammatory joint conditions (rheumatologist).

Here’s some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

Questions to ask the doctor at the initial appointment include:

Questions to ask if you’re referred to a rheumatologist include:

If any additional questions occur to you during your medical appointments, don’t hesitate to ask.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

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