What are the symptoms of a gout attack, what causes it, and how can it be preven

Symptoms of a Gout Attack: Gout attacks typically present with a rapid onset, often overnight, of severe joint pain, accompanied by redness and swelling ¹. While most commonly affecting the first metatarsophalangeal (MTP) joint of the foot, gout can also affect other joints such as the midfoot, ankle, knee, hand, or wrist ¹. In some cases, chronic gouty arthritis may present with chronic inflammatory joint pain ¹.

Causes of Gout: Gout is caused by high levels of urate in the blood, which leads to the formation of urate crystals in the joints ¹,². Risk factors for gout include genetics, excess body weight or obesity, certain medications, and comorbidities such as chronic kidney disease (CKD) and hypertension ¹,². Hyperuricaemia and gout are also independent risk factors for cardiovascular disease ².

Prevention of Gout Attacks: While there is insufficient evidence to recommend specific diets for preventing flares or lowering serum urate levels, a healthy, balanced diet is advised ¹. Patients should be advised that excess body weight or obesity, and excessive alcohol consumption, may exacerbate gout flares and symptoms ¹. For individuals with gout, particularly those with multiple or troublesome flares, CKD stages 3-5, diuretic therapy, tophi, or chronic gouty arthritis, urate-lowering therapy (ULT) is recommended using a treat-to-target strategy ². ULT is typically a lifelong treatment aimed at eliminating urate crystals and preventing future flares ². Lifestyle advice should also be provided, and comorbidities such as cardiovascular risk factors and CKD should be assessed and managed ¹,².