Understanding The 4 Stages of Gout

 Understanding The 4 Stages of Gout

More than 8 million people in the United States deal with gout, an arthritic condition that can cause severe joint pain. At the University Executive Physical Program, Shawn Veiseh, MD, can diagnose and manage the complications of gout. In this blog, he explains the stages of gout and how it can be treated.

The four stages of gout

Gout is a complex form of arthritis that affects the joints, causing pain and swelling. Weight, diet, age, and certain medical conditions can all affect your risk of getting gout.


Hyperuricemia occurs when there’s too much uric acid in the blood. Uric acid is a normal waste product that is produced when your body breaks down purines. Purines are naturally in your body and they’re also in some foods. Consuming lots of purine-rich foods, such as seafood, beer, and drinks high in fructose can increase your chances of getting hyperuricemia. 

Typically, your body removes uric acid by dissolving it in your blood and passing it through your kidneys. The uric acid is then eliminated when you urinate. If uric acid is not eliminated, and it keeps building up, you have hyperuricemia. This stage of gout usually has no symptoms.

Acute gout attack

When uric acid builds up to a high level, it can begin to form urate crystals. These crystals often collect in joints, most often the joints at the base of the big toes. It’s these crystals that cause the inflammation, redness, swelling, and pain of a gout attack. A gout attack can last up to 10 days, and you may not get another attack for months or even years. For some, an attack may never happen again, but if left untreated, the condition can wear away at joints and destroy them.

Intercritical gout

Intercritical gout is best described as the stage between attacks, where there are no symptoms, but the buildup of urate crystals is still happening. In this stage, you are still at risk of another attack, and the potential for joint damage is still present. If you’ve had a gout attack once, you’re likely to have one again in the future.

Chronic tophaceous gout

At this point, the crystals in your joints have formed into a substance called tophi, and your affected joints likely have permanent damage at this stage. The tophi may continue to cause redness and swelling in your joints, and treating gout damage at this stage would likely require taking specialized medications.

The best ways to avoid or prevent further gout attacks is to drink plenty of water, limit alcohol consumption, reduce meat intake, and eat low-fat dairy products for your source of protein. Steroids are often used to treat gout inflammation and pain, and other drugs are often used to control uric acid production.

If you’re suffering from gout or want to see if you are, we can help. To learn more, book an appointment online or over the phone with the University Executive Physical Program today.

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