Gout is a type of arthritis caused by a build-up of uric acid crystals in a joint, leading to sudden attacks of severe pain, swelling, redness and heat, most often in the big toe. Attacks usually settle within 1 to 2 weeks, but without long-term treatment to lower uric acid, they tend to come back and can damage joints and kidneys.
Symptoms of a gout attack
- Sudden, intense joint pain, often starting at night
- The joint is swollen, hot, red or shiny, and very tender (even a bedsheet can hurt)
- Commonly the big toe, but also ankles, knees, fingers, wrists and elbows
- Over years, hard lumps of crystals (tophi) may form under the skin
Risk factors and triggers
- Male sex and older age; women’s risk rises after menopause
- Obesity, high blood pressure, diabetes and kidney disease
- Alcohol, especially beer and spirits
- Sugary drinks and fructose
- Large amounts of red meat, organ meat (liver, kidney) and some seafood
- Diuretics (“water pills”) and low-dose aspirin
- Dehydration, illness, surgery or crash dieting
Foods and drinks to limit
- Beer, spirits and large amounts of wine
- Sugary soft drinks and fruit juices with added sugar
- Organ meats such as liver, kidney and tripe
- Large portions of red meat
- Some seafood, especially sardines, anchovies, mackerel and shellfish
Helpful: plenty of water, low-fat dairy, vegetables, whole grains and a healthy weight. Diet alone rarely controls gout, but it reduces attacks.
Treating a gout attack
- Anti-inflammatory medicines such as NSAIDs, colchicine, or a short course of steroids, as prescribed and depending on kidney function and other conditions
- Rest and raise the joint
- Ice packs wrapped in a cloth for up to 20 minutes
- Keep bed covers off the joint
- Drink plenty of water
Long-term prevention
- Urate-lowering therapy such as allopurinol or febuxostat is recommended for people with frequent attacks, tophi, kidney problems or joint damage
- Usually started at a low dose and increased gradually, with blood tests to reach a target uric acid level
- Attacks can flare when treatment starts, so a preventive medicine such as colchicine may be prescribed for the first months
- Don’t stop allopurinol during an attack unless your healthcare provider says so
When to see a healthcare provider urgently
- Fever with a hot, swollen joint (possible septic arthritis, an emergency)
- First attack, to confirm the diagnosis
- Attacks keep coming back
- Pain not improving after a few days of treatment
Nursing points
- Assess pain, joint, temperature and kidney function
- Review medicines that raise uric acid
- Educate on adherence to urate-lowering therapy, which is often poor
- Support weight loss and alcohol reduction without blame
Frequently asked questions
Can gout be cured?
It can’t be cured permanently, but with uric acid lowered to target, attacks can stop and tophi can dissolve.
Can women get gout?
Yes, especially after menopause.
Are tomatoes bad for gout?
Some people report tomatoes as a trigger, but evidence is limited. Keep a food diary to identify your own triggers.
Related reading: Chronic kidney disease nursing care · Hypertension patient education · Pain assessment tools
Checked against NHS guidance on gout. Updated 5 November 2026.
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