Gout | Better Health Channel
For hot weather and health alerts this summer, download the Better Health Channel app today. For hot weather and health alerts this summer, download the Better Health Channel app today.
Close survey
Gout

Summary

Gout is a common form of arthritis. Pain often occurs in the big toe joint, knee, ankle, elbow and other joints. A gout attack is sudden and painful. Gout is caused by a build-up of a waste product, uric acid, in the bloodstream. Excess uric acid settles in joints, causing inflammation, pain and swelling. Alcohol, overeating, dieting and dehydration can trigger a gout attack.

Download the PDF version of this fact sheet Email this fact sheet

Gout is a common form of arthritis characterised by recurrent attacks of extreme pain, swelling and redness. Gout is more common in men, and often several men of the one family can be affected by gout.

While most other types of arthritis develop slowly, an attack of gout happens suddenly, often overnight. The most commonly affected joint is the big toe, but gout may be experienced in the feet, ankles and knees, and less commonly in the elbows, hands and other joints. For some people, even the weight of a bed sheet can cause intolerable pain.

Causes of gout


Gout occurs when uric acid builds up in the bloodstream and deposits urate crystals in the joint. These crystals form slowly over months or years. The build-up of uric acid is most commonly caused by under-excretion of uric acid by the kidneys, but may also be caused by the overproduction of uric acid by the body.

Some people have higher levels of uric acid in their bloodstream when compared to others. This condition is called hyperuricaemia and can be hereditary. Other causes of gout can include the use of diuretics (fluid tablets), which can cause the retention of too much uric acid.

Risk factors of gout


A person with gout is more likely to have an attack when they:
  • have elevated levels of urate in the blood
  • consume too much alcohol (particularly beer)
  • consume a diet high in ‘purines’ such as meat, sweetbreads, offal, shellfish, and fructose (found in fruit juices and soft drinks sweetened with corn syrup)
  • are obese
  • use diuretics
  • injure a joint
  • have an operation
  • become dehydrated
  • are unwell with a fever
  • crash diet or fast.

Dealing with an attack of gout


Without treatment the attack usually resolves within one or two weeks, and with medication, it can be resolved within several days. However, the crystals still remain in the joint.

If you have not had an attack of gout before, your doctor will look for elevated urate levels in your blood and may aspirate (remove a sample of fluid from the joint) to make a definite diagnosis. If you have gout, uric acid crystals can be seen in large numbers under a microscope.

Once the diagnosis is confirmed, your doctor will consider various treatment options including:
  • non-steroidal anti-inflammatory drugs (NSAIDs)
  • colchicine
  • corticosteroids injections or tablets.
Some of these medications have side effects – your doctor will be able to advise the most appropriate treatment for you. In an acute attack, applying an ice pack to the painful joint for 10-15 minutes at a time and protecting or resting the joint can help to reduce pain.

Early diagnosis and treatment is very important. The primary goal in everyday management is to reduce the level of uric acid in the blood so it cannot form crystals in the tissues or joints and cause joint damage. The benefits of reducing uric acid in the blood long term include:
  • slowing the progress or risk of kidney disease, which may be caused by deposits of urate in the kidneys
  • possibly reducing the risk of heart disease.
If you have frequent episodes of gout, your doctor may prescribe medications to reduce the formation of uric acid and increase the excretion of uric acid.

Changes to lifestyle can help in the long term


The methods of managing an acute attack of gout differ from the ongoing methods for managing gout. If you suffer from gout you will benefit in the long term from making healthy changes to your lifestyle.

Suggestions to help in the self-management of gout include:
  • Maintain a healthy body weight. If you do need to lose weight, make sure your weight loss is gradual as ‘crash’ diets can increase uric acid levels.
  • Cut down on alcohol consumption and avoid binge drinking.
  • Keep hydrated – drink plenty of water.
  • Consult a dietician to get advice on a healthy and well balanced diet
  • Exercise regularly – aim to complete at least 30 minutes of physical activity most days of the week.
  • Work closely with your doctor to prevent further attacks and actively manage your condition.

Where to get help

  • Your doctor
  • Rheumatologist
  • Arthritis and Osteoporosis Victoria Tel. (03) 8531 8000 or 1800 263 265

Things to remember

  • Gout is a type of arthritis caused by too much uric acid in the bloodstream.
  • Excess uric acid settles in joints and causes pain and swelling.
  • Healthy lifestyle choices combined with a correct treatment program should mean that gout can be successfully managed.

You might also be interested in:

Want to know more?

Go to More information for support groups, related links and references.


This page has been produced in consultation with and approved by:

Arthritis Victoria

(Logo links to further information)


Arthritis Victoria

Last reviewed: October 2014

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your doctor or other registered health professional. Content has been prepared for Victorian residents and wider Australian audiences, and was accurate at the time of publication. Readers should note that, over time, currency and completeness of the information may change. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions.


If you would like to link to this fact sheet on your website, simply copy the code below and add it to your page:

<a href="http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Gout?open">Gout - Better Health Channel</a><br/>
Gout is a common form of arthritis. Pain often occurs in the big toe joint, knee, ankle, elbow and other joints. A gout attack is sudden and painful. Gout is caused by a build-up of a waste product, uric acid, in the bloodstream. Excess uric acid settles in joints, causing inflammation, pain and swelling. Alcohol, overeating, dieting and dehydration can trigger a gout attack.



Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

For the latest updates and more information, visit www.betterhealth.vic.gov.au

Copyight © 1999/2014  State of Victoria. Reproduced from the Better Health Channel (www.betterhealth.vic.gov.au) at no cost with permission of the Victorian Minister for Health. Unauthorised reproduction and other uses comprised in the copyright are prohibited without permission.

footer image for printing