Most people with gout are treated by a primary care physician, and less than 10 percent of patients are referred to a rheumatologist, notes Everyday Health. Sometimes patients receive counseling from a dietitian because treatment often involves medication and dietary changes, which can help reduce the frequency of flare-ups.
Under normal conditions, the body breaks down substances called purines into uric acid and deposits this acid into the blood, explains Mayo Clinic. Uric acid is then processed by the kidneys and excreted in the urine. Gout develops when the body either produces too much uric acid or does not get rid of it well. Uric acid builds up in the blood and deposits in the joints where it forms crystals that cause inflammation and pain.
Some gout flare-ups occur without an apparent cause. Others can be related to medication side effects, diet, a hereditary condition or surgery, according to Mayo Clinic. Red meat and alcohol are substances that are rich in purines and are known to increase gout flare-ups. Medications such as aspirin, niacin and diuretics can also increase uric acid concentration in the blood.
Gout flare-ups are sometimes brought on by rapid weight loss, hypertension and surgery, explains Mayo Clinic. Hereditary conditions such as Kelley-Seegmiller syndrome and Lesch-Nyhan syndrome cause an elevation of uric acid in the blood because of a deficient or missing enzyme that controls uric acid levels.