What really triggers a gout attack?


Quick Answer

The formation of needle-shaped crystals of uric acid in the joints and surrounding tissue causes inflammation and intense pain in the affected joint, which is the chief symptom of gout. Uric acid comes from purines, which the body normally flushes out unless consumption is excessive, notes Mayo Clinic.

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Full Answer

Normally, the blood dissolves uric acid, sending it through the kidneys as part of urine; however, there are times when the body generates too much uric acid or the kidneys do not get rid of enough. The excess acid crystallizes, settling in joints and surrounding tissue, causing the painful outbreaks that typify gout, explains Mayo Clinic.

Gout occurs in three stages, states WebMD. Many people go through the first stage without knowing it because there are no symptoms other than elevated levels of uric acid. In some people, the excess acid leads to kidney stones before symptomatic gout occurs.

The second stage involves crystal formation, generally in one big toe, states WebMD. This stage involves cycling between pain in the joint and normal levels of feeling. Over time, the painful periods last longer, become more intense, and spread to multiple joints.

The third stage involves the formation of nodules known as tophi beneath the skin, and the pain can remain constant. Without treatment, the tophi spread to the cartilage of the outer ear or to tissues of affected joints. Progressive stages of crippling can result, although this is rare because most patients seek treatment at earlier stages, according to WebMD.

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