Home > Health conditions > Bones & joints > Arthritis & related disorders > Gout >

Overview of gout

Mō te porohau

This page has links to information in other languages.

Gout is a form of arthritis caused by uric acid (also called urate).

A lot of people think that gout is caused by food and drink such as seafood, meat and beer. But what you eat and drink only makes a small difference to your uric acid.

High uric acid is mainly affected by your genes (passed on by your parents), your kidneys and your weight.

Your kidneys usually filter out extra uric acid, which then comes out in your wee (urine).

If you do not get rid of enough uric acid, the levels in your blood increase. The uric acid can then turn into tiny, sharp, glass-like crystals that collect in your joints causing gout.

The crystals can also cause lumps under your skin called tophi.

Māori and Pacific peoples are more likely to have the gene that stops their kidneys getting rid of enough uric acid.

Symptoms of gout

Gout causes severe pain, swelling and redness in one or more of your joints. It often affects your big toe but can affect your knee, foot, wrist, ankle, hand and elbow joints.

It can come on suddenly and often starts at night.

Diagnosing gout

Your healthcare provider will ask you about your symptoms and examine the affected parts of your body. They can usually diagnose gout by examining your sore joint. They will arrange a blood test to measure your uric acid levels. This can either be at the time of your attack, or later.

If it is not clear whether you have gout or a joint infection, you may need to have a procedure called a joint aspiration. This involves taking fluid out of the affected joint using a needle and syringe. The fluid is sent to a laboratory to be tested.

Treating an attack of gout

Anti-inflammatory medicines are used for an attack of gout. These include non-steroidal anti-inflammatories (NSAIDs) and colchicine. Also, a class of drugs called corticosteroids, most often prednisone.

All anti-inflammatories can have serious side effects, especially if used for more than a few days. This is especially important if you have other health conditions and are on other medicines.

Your general practice team will discuss the medicines with you and give you advice on what is most appropriate for you.

Medicines to prevent gout

If you have had more than two attacks of gout in a year, complications of gout or a strong family history, your doctor will recommend you take medicine to lower the uric acid in your blood. This will reduce your chance of getting acute gout and long-term damage.

The goal with this medicine is to keep your uric acid levels below 0.36 mmol/L. You will need blood tests to check your levels.

You usually start the medicine at a low dose and increase it slowly to reduce side effects.
It can take weeks to months to work, and you may get gout attacks when you are first taking it. You may need to take an anti-inflammatory medicine with your preventer for the first few months.
It is important to take your urate-lowering medicine every day, even when you feel well. Continue taking it while you have a gout attack.
Urate-lowering medicine is a long-term treatment that you have to continue taking for many years.
- Allopurinol is the most commonly used urate-lowering medicine.
- If you cannot take allopurinol, your doctor may prescribe another medicine such as probenecid or febuxostat.