While it is most common in the big toe, gout can occur in any joint when uric acid levels are high. Uric acid is a byproduct of the way our bodies break down proteins called purines, so it is always present in the body. Levels can climb in people with kidney problems, those with diabetes, who are overweight or who consume large amounts of alcohol.

 

Other risk factors for gout include surgery or trauma and medications that treat high blood pressure. A flare up can be sudden and severe, with joints becoming swollen with excess fluid. A doctor can diagnose gout by removing some of this fluid and testing for uric acid crystals. Doctors also can identify gout by the presence of tophi, hard nodules of uric acid deposits under the skin at the affected joints. Patients with tophi have typically had a high uric acid level for some time and may need more aggressive treatment.

 

Those susceptible to gout can help prevent attacks by staying hydrated and by avoiding foods that are high in purines. Foods to avoid include alcoholic beverages, sweet breads, some fish and seafood, such as anchovies, sardines, mussels and trout, and some meats, such as bacon, liver and beef kidney. Other seafood and meat may have a moderate purine level and should consumed in moderation. Patients should be aware of foods and activities that trigger attacks and attempt to limit them.

 

Untreated gout can cause permanent joint damage and deformity.