Gout is a form of inflammatory arthritis. It can occur when high levels of uric acid, a waste product, build up in the blood. This causes swelling and joint pain. Complications of gout include joint damage, kidney damage, and bone loss.

This excess uric acid causes needle-shaped crystals to form around joints, leading to inflammation in and around the joints.

People may notice gout symptoms in one joint at a time, and the condition can often start in the big toe. Without proper treatment, individuals may experience symptoms in more joints throughout the body over time.

Gout can cause the following symptoms around the joints:

  • swelling
  • redness
  • warmth
  • tenderness
  • pain, which may feel excruciating if anything touches the joint
  • difficulty moving

Symptoms of gout can come and go. People with the condition may have a flare-up where they experience symptoms that may last for 1–2 weeks then resolve.

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Gout will not directly cause death, but it may lead to life threatening complications without proper treatment.

According to the Arthritis Foundation, gout can increase the risk of cardiovascular problems, including heart failure, heart attack, and stroke. Although several factors may cause this, a buildup of uric acid crystals may damage blood vessels.

Gout also increases the risk of type 2 diabetes, with a 71% increase for females and a 22% increase for males. This may be due to high levels of inflammation. People with gout may also be more likely to be overweight and have high blood pressure or high cholesterol.

Gout may also increase the risk of moderate kidney disease by 78%. Without treatment, kidney disease may progress to kidney failure.

Additionally, gout may double the risk of sleep apnea, a condition that affects breathing during sleep. Sleep apnea can increase the risk of serious health problems, including:

  • obesity
  • diabetes
  • high blood pressure
  • heart attack
  • stroke

Tophi are collections of urate crystals consisting of uric acid buildup, which can develop on joints and cartilage. These hardened crystals can cause bumps of varying sizes to form on parts of the body, including the:

  • fingers and hands
  • feet and toes
  • ankles
  • elbows
  • the ears

Tophi is a sign of chronic gout and can develop in people who have frequent gout flares. Although tophi are not usually painful, they can cause joint damage, making it more difficult to move the joints.

Tophi can also lead to complications without treatment. If they contract an infection or press on a nerve, it can cause pain and be dangerous.


Lowering uric acid levels helps treat tophi. This may involve medication, such as allopurinol, which reduces uric acid in the body. To get rid of the tophi, a doctor may increase the dosage of uric-acid lowering medications to prevent the uric acid from crystallizing.

Treatment for tophi can take time, and people may not notice a reduction in the size of the tophi until several months of treatment. In severe cases, individuals may require surgery to remove tophi.

Chronic gout can cause frequent swelling of the joints and chronic inflammation, which can cause joint damage. People may also experience stiffness and deformity.


It is important to keep gout flare-ups under control to help prevent joint damage. The Arthritis Foundation recommends the following steps to control swelling due to gout quickly:

  • Make an appointment with a doctor to assess the condition.
  • Apply ice to the joint and elevate it.
  • Drink plenty of fluids, such as water, and avoid alcohol or sugary sodas.
  • Try and manage or reduce stress, which can worsen gout flare-ups.
  • Ask for help with any tasks that could put extra strain on the joints.

In addition, certain medications can help lower inflammation and shorten a gout flare, including:

In severe cases, people may require surgery to repair joint damage or replace severely damaged joints.

Some researchers have claimed that gout may cause an increased risk of bone fractures, although there is some controversy around this claim.

Researchers in a 2016 study concluded that their findings suggested there was indeed a higher risk of bone fracture in people with a history of gout.

The researchers noted that participants with gout who were taking medication for the condition, namely allopurinol and benzbromarone, had lower instances of bone fractures than those who were not.


If people have gout and bone loss, certain medications, called bisphosphonates, can help reduce or prevent further bone loss. These include:

  • alendronate
  • risedronate
  • ibandronate
  • zoledronic acid

People with gout have an increased risk of developing kidney stones. High levels of uric acid can cause urate crystals to collect in the urinary tract and form them. Symptoms of kidney stones include:

  • severe pain in the back, groin, lower abdomen, or side below the ribs
  • pain when urinating
  • brown, red, or pink urine


If people have kidney stones from gout, doctors may use a drug called allopurinol and an alkalizing substance to dissolve the urate stone.

The kidneys remove waste products, such as uric acid, from the body. When there are high levels of uric acid, the kidneys can struggle to process the excess levels.

If uric acid crystals build up in the kidneys, it can impair kidney function and may lead to kidney disease or kidney failure.

In the early stages of kidney disease, it can cause people to feel fatigued, and they may feel tired, weak, or have low energy. As kidney disease progresses, individuals may experience:

  • swelling of the ankles
  • nausea
  • fatigue
  • a loss of appetite


Treatment can help reduce and slow damage to the kidneys. Treatments can include:

  • taking medications to lower uric acid levels, such as allopurinol, febuxostat, probenecid
  • reducing foods high in purine, such as organ meats and shellfish
  • drinking plenty of water
  • avoiding smoking and certain supplements, such as niacin (vitamin B-3)
  • exercising regularly and maintaining a moderate weight
  • controlling any other conditions, such as high blood pressure or diabetes

Although eye issues are a rare complication of gout, uric acid crystals may affect parts of the eyes, including the eyelid, cornea, and iris. Tophi can also affect other areas of the eyes, such as the upper eyelid.


Treating gout by lowering uric acid levels and inflammation can help treat any eye problems resulting from gout. Prompt treatment of flare-ups is important, and it usually involves using anti-inflammatory drugs such as NSAIDs or corticosteroids.

Dietary and lifestyle changes and medications to lower uric acid levels can also help.

The following steps can help reduce the risk of gout complications:

  • limiting or avoiding foods high in purine, alcohol, and sweet fruit drinks to reduce uric acid buildup
  • taking medications to lower uric acid or accelerate its removal
  • drinking plenty of water
  • getting regular kidney function and bone density tests to check for early signs of any problems
  • eating a nutritious, balanced diet
  • maintaining a moderate weight
  • engaging in regular exercise
  • controlling any additional conditions, such as high blood pressure or diabetes

Dietary and lifestyle changes, such as the ones above, may help manage gout and reduce the risk of frequent gout flare-ups.

To manage gout and help prevent flare-ups, people may need long-term management with low, regular doses of medication to control uric acid levels. Individuals may need to take colchicine along with one of the following:

  • allopurinol
  • febuxostat
  • probenecid

If uric acid levels are still especially high and the above medications are not effective at their maximum recommended dosages, an intravenous dose of pegloticase every 2 weeks may work rapidly to reduce uric acid.

If people have a gout flare-up, they can contact a doctor to discuss optimal treatment options. Treatments that lower inflammation are most effective within 24 hours of a gout flare-up.

People need to contact a healthcare professional if they have any signs of gout complications. And if they have any symptoms of a cardiac event, such as stroke or heart attack, they will need immediate medical attention.

Although gout is not directly fatal, without treatment, it can lead to dangerous complications, including joint damage, cardiovascular problems, and kidney disease.

Controlling gout flare-ups and reducing uric acid levels with medications and dietary and lifestyle changes can help manage gout and reduce the risk of complications.