Gout can cause flare-ups, which are periods where symptoms worsen. Triggers can include eating certain foods, dehydration, and other factors.

Gout is a rheumatic disease that causes chronic inflammatory arthritis.

It can cause flare-ups, which are sudden periods where a condition intensifies. These flare-ups can start in different joints, though they typically begin in one of the big toes.

Flare-ups often start at night with a sudden onset of severe pain. They can also cause swelling, discoloration, heat, and stiffness in the joints.

Flare-ups generally resolve within 1–2 weeks, and there are typically no symptoms between flare-ups. However, gout affects people differently, with some experiencing frequent flare-ups and others going for years without.

This article goes over some of the factors that can cause gout flare-ups.

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Dietary factors can cause gout flare-ups, including high purine foods and alcohol, among others.

Purine-rich foods

Purine is a type of chemical compound that produces uric acid during metabolism. This can cause the body to produce too much urate, which can trigger gout. Urate forms gout crystals in and around the joints, leading to joint pain and inflammation.

Purine-rich foods include:

Alcohol

Consuming alcohol can increase the risk of gout, according to 2015 research. This is because alcohol contains purines, which the body breaks down into uric acid. Alcohol also affects the rate at which the body excretes uric acid. Finally, alcohol increases the breakdown of molecules called nucelotides, which also contain purine.

Research from 2014 indicates that all types of alcohol can increase the risk of a gout flare-up, but that the risk is highest when drinking beer and spirits.

Sugary beverages

Juices with sugar-sweetening and drinks that contain high fructose corn syrup, such as soft drinks, can contribute to a high uric acid concentration in the body, increasing the risk of gout.

Certain medications can increase the risk of gout flare-ups. These include:

  • diuretics, which increase urine production
  • low dose aspirin, as this can increase uric acid level in the blood
  • large quantities of niacin, a form of vitamin B
  • cyclosporine, an immunosuppressant

There are various medical conditions and factors that increase a person’s risk of developing gout and can also increase the risk of gout flare-ups.

Dehydration

Dehydration causes the uric acid level in the blood to increase, as there is not enough water to dilute the uric acid. This has a pro-inflammatory effect, which can trigger gout flare-ups.

Diabetes and prediabetes

Having an existing condition that affects the cardiovascular system, such as diabetes, increases the risk of gout flare-ups.

Diabetes mellitus, or diabetes, affects oxidative phosphorylation, which is part of the final stage in the process of breathing. This increases adenosine, a chemical in the cells, which increases the level of uric acid the body produces and decreases how much urine a person excretes.

Obesity

As with diabetes, obesity is a condition that affects the cardiovascular system, which can increase gout flare-ups.

Having a higher body mass index (BMI) is a strong risk factor for a high uric acid level and, therefore, gout.

Injury and inflammation

Joint injuries can trigger gout flare-ups if a person already has a high concentration of urate crystals in the cartilage.

This is because the injuries trigger a defense mechanism that causes the white blood cells to take up the urate crystals and release inflammatory chemicals called cytokines, which speed up the inflammatory process.

Other factors

Other factors that can influence the risk of gout and gout flare-ups include the following:

  • genetics
  • older age
  • being assigned male at birth
  • having certain other conditions at the same time
  • cold weather

Treatment plans for gout flare-ups aim to reduce symptoms, including inflammation. This can include medication and nonpharmaceutical methods. Medications a doctor may prescribe include:

Nonpharmaceutical treatments include applying ice packs, resting, and undertaking the following lifestyle modifications:

  • reducing alcohol intake, if applicable
  • avoiding purine-rich foods
  • reaching or maintaining a moderate weight
  • staying hydrated

Without treatment, gout flare-ups are likely to be longer and more frequent.

The following are some questions people frequently ask about gout and gout flare-ups.

What is the main trigger for gout?

The main trigger varies from person to person, as genetic and environmental factors influence the likelihood of a gout flare-up.

What is the fastest way to get rid of a gout flare-up?

Short-term treatment strategies for gout flare-ups typically focus on decreasing inflammation and pain, taking medication to help ease symptoms, and resting with ice packs.

Gout is a form of arthritis that causes sudden flare-ups of pain and inflammation, often beginning in one of the big toes. It occurs when the concentration of urate is too high, creating crystals in the joints.

There are different reasons why gout may flare up, with factors including eating foods that contain high purine concentrations, having a high alcohol intake, taking certain medications, and being dehydrated.

Individuals can help prevent or reduce gout flare-ups by reducing alcohol intake, reaching or maintaining a moderate weight, and keeping hydrated.