Gout attack symptoms often develop rapidly overnight and worsen over the next 24-48 hours.

• They can be triggered by many things including:
  • Joint injury or other trauma
  • Surgery or sudden, severe illness
  • Psoriasis flares
  • Infection
  • Certain medications, such as chemotherapy, diuretics, or intravenous contrast media
  • Crash diets and fasting
  • Drinking too much alcohol
  • Eating large portions of certain foods high in purines
  • Dehydration (not getting enough fluids)
  • Fructose sweetened drinks
• They can happen one time, several times, or chronically.

A single gout attack usually only affects only one joint, but recurrent attacks may affect more than one joint. The big toe is the most common site of gout. Other sites include the ankle, heel, foot instep, wrist, elbow, or fingers.

Gout of the Big Toe

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Common symptoms in the joint include:

• Severe pain and sensitivity of the joint
• Extreme tenderness
• Swelling
• Redness
• Warmth

Fever and flu-like symptoms may also be present.

Recurrent attacks can lead to permanent joint damage, especially if gout remains untreated. Uric acids can build up and create deposits called tophi. They can lead to:

• Hard lumps under the skin near or around joints
• Hard lumps at the rim of the ear, fingertips, cornea of eye, aorta, spine, or around the brain

High levels of uric acid in the body can also lead to complications in other areas of the body, such as the kidney stones or chronic renal failure.