Gout

What is gout?

Gout is a type of joint pain that comes on suddenly and can be very painful. It happens when a chemical called uric acid builds up in your blood and forms tiny crystals around your joints. These crystals cause swelling and severe pain.

What does gout feel like?

The main signs of gout are:

• Sudden, severe pain in a joint - usually your big toe, but it can affect your feet, ankles, hands, wrists, elbows or knees
• Hot, swollen, red skin over the painful joint (the redness might be harder to see on darker skin)

The pain often starts at night and can be so bad that even a bedsheet touching the joint hurts.

When to see your GP

Speak to your GP if:

• You think you might have gout for the first time
• You have gout and your usual treatments aren't working

Get urgent help from your GP or call 111 if:

• Your joint pain is getting worse
• You have a very high temperature or feel hot, cold or shivery
• You feel sick or cannot eat

These symptoms could mean you have an infection in your joint, which needs urgent treatment.

What causes gout?

Gout happens when you have too much uric acid in your blood. This chemical comes from breaking down certain foods and drinks. Some people are more likely to get gout if they:

• Are overweight
• Drink alcohol regularly
• Take certain medicines (like water tablets or blood pressure medicines)
• Have other health conditions like high blood pressure, diabetes or kidney problems
• Have family members with gout

What can trigger an attack?

Gout attacks might happen if you:

• Have an illness with a high temperature
• Drink too much alcohol or eat a very large meal
• Get dehydrated (don't drink enough water)
• Injure a joint
• Take certain medicines

How is gout treated?

During an attack:

• Pain medicines like ibuprofen can help
• Your GP might prescribe stronger medicines or steroid tablets
• Rest the affected joint and keep it raised
• Apply ice wrapped in a towel for up to 20 minutes at a time
• Drink plenty of water
• Keep bedclothes off the painful joint

To prevent future attacks: If you get gout often, your GP might prescribe medicine to lower uric acid levels in your blood. It's important to take this regularly, even when you feel fine.

How to help prevent gout

• Lose weight if you're overweight (but avoid crash diets)
• Eat a healthy diet - your GP can give you advice about foods to limit
• Have some alcohol-free days each week
• Drink plenty of water to stay hydrated
• Exercise regularly but avoid putting too much pressure on joints
• Limit sugary drinks and snacks

What happens if gout isn't treated?

Without treatment, gout attacks can last 1-2 weeks and may get worse over time. Long-term untreated gout can cause permanent joint damage and hard lumps under your skin.

Remember, if you think you have gout, speak to your GP. They can do a simple blood test to check your uric acid levels and help you manage the condition.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.