Gout happens when urate crystals get deposited into joints triggering a very painful inflammatory reaction in that joint, most commonly the big toe joint. The urate crystals typically end up in the joints when there is too much in the blood and trying to put them into the joint is the body’s way to reducing the blood levels, obviously not a very successful way it it creates pain, causing gout.
Typically the kidneys get rid of the excessive uric acid levels but for a number of reasons that kidneys can not cope. They may not be able to cope as the body is producing too much of the urates or it could be there is a problem with the kidneys and it can not cope with the amount that it needs to excrete.
So gout is causes either by:
1. Overproduction of urates
2. Under excretion of urates
You could be taking in too much food that is high in purines (they get converted to urates by the body); a disease that affects the kidney (eg diabetes, high blood pressure); a genetic defect that affects the enzymes involved in getting rid of the urates; some drugs (eg diuretics); too much alcohol.
Gout is treated long term by dealing with that overproduction and the under excretion.