Gout usually occurs in 'attacks'. An attack typically develops quickly over a few hours. It usually causes severe pain in one joint. The base of the big toe is the most commonly affected joint. Walking can be very painful and even the weight of bedclothes can hurt.

However, any joint can be affected. Sometimes two or more joints are affected. Affected joints usually swell, and the nearby skin may look red and inflamed. If left untreated, a gout attack may last several days, but usually goes completely within 7-10 days. Less severe attacks can occur which may be mistaken at first for other forms of arthritis. Weeks, months or even years may go by between attacks. Some people only ever have one attack.

Is gout serious?

Although a gout attack can be very painful, it is uncommon to cause other problems even if it is not treated. Joint damage may occur if you have recurring attacks. In a few people, uric acid crystals form kidney stones. Sometimes the crystals form bumps (tophi) under the skin. These are usually harmless and painless, but sometimes form in awkward places such as at the end of fingers.

How is gout diagnosed?

Gout is usually diagnosed if you have the typical symptoms and a raised blood level of uric acid. If there is doubt as to the cause of the pain and swelling, your doctor may take some fluid out of a swollen joint. This is done with a needle and syringe. The fluid is looked at under the microscope. Crystals of urate (uric acid) can be seen in the fluid to confirm the diagnosis of gout.

What can I do if I have recurring gout attacks?

• If you are overweight, try to lose some weight. This can help to lower the uric acid level.
• If you drink a lot of alcohol then it may help if you reduced the amount that you drink. You do not need to stop drinking alcohol altogether, but cutting down may help if you drink a lot.
• If you are taking any medicines, check whether they are a cause of gout (see above). An alternative medicine may be available. Your doctor will advise.
• Have your blood pressure checked at least once a year. High blood pressure is more common in people with gout.

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