Gout, as it is now known, is caused by the local formation of crystals of sodium urate in the joints. Gout is often episodic (sudden onset, a few hours away) with red, swollen, painful joints and painful joints that are hot to the touch. There are two sources of uric acid in the human body: 1) from the metabolism of purines in food (about 20%); 2) from the body’s own purine metabolism (about 80%). There are also two main ways to excrete uric acid: 1) through the kidneys (most of them); 2) through the intestines (a small amount). The following chart will be more intuitive: before the gout attack, there is often elevated blood uric acid that is hyperuricemia. Elevated blood uric acid is a combination of the above mentioned uric acid production and uric acid excretion: 1) increased uric acid production in the uric acid production pathway; 2) decreased uric acid excretion in the uric acid excretion pathway; 3) a combination of the above two factors. Throughout the course of gout, most do not have swollen and painful joints every day, but have severe pain during the attack period and can be asymptomatic during the interval (except for long gout stones). During the interval many patients think they are well, but in fact they are not. These patients often have several repeated attacks of gout, becoming more frequent and with shorter and shorter intervals between attacks, before people really make up their minds to treat them. Unfortunately, most people have pain relief and then get lucky and stop taking their medication, eat indiscriminately, drink alcohol, to name a few. What needs to be clear is that gout without attacks is also harmful if blood uric acid remains high. High uric acid can cause high blood pressure, can cause diabetes, and even cerebrovascular disease such as stroke. Therefore, it is important to take medication to lower blood uric acid even when gout is not painful, in addition to reducing the chance of a gout attack, and also reducing the risk of hypertension, diabetes, and stroke. However, if you have an acute attack of gout, you should not take uric acid-lowering drugs (if you are already taking uric acid-lowering drugs before and during the attack, you can continue to take them), but you have to wait until the acute inflammation has passed, and then gradually add uric acid-lowering drugs (the specific uric acid-lowering drugs to be used will depend on different situations). Sometimes uric acid-lowering drugs can also be used under the premise of using anti-inflammatory and analgesic drugs, and it is also necessary to consult a rheumatologist on how to use them. Based on our national situation at this stage, it is not recommended to seek treatment for gout from non-rheumatologists. The common causes of recurrent attacks of gout that I encountered in my clinical work are: 1, diet is not moderated: wine as usual, seafood as usual, how can it not attack? 2, the autologous metabolism of uric acid is not controlled; 3, uric acid excretion from the kidneys is reduced; 4, fluke psychology or unauthorized drug withdrawal and reduction; 5, although in treatment, but no monitoring, treatment goals are not achieved. For example: blood uric acid is not reduced to below 300umol/L; or the blood uric acid is reduced to below 300umol/L once, but it is higher than 300umo/L in other times. Some patients mistakenly think that they can stop the medication when it is reduced to below 300umol/L, but they do not know that primary gout needs lifelong treatment and medication is always needed. Therefore, some patients check to reduce to below 300umol/L once, and then reduce the medication by themselves, because the disease still exists, without the control of medication, the blood uric acid will rise again, thus increasing the chance of gout recurrence. Gout is one of the rheumatic diseases that is relatively easy to control and achieve better results, but it is a pity that a significant number of patients have recurrent relapses. The reason why it is difficult for patients to adhere to the required treatment may be related to the fact that the disease has a long interval, which makes it easy for people to get lucky and think that they are well. Therefore, some patients pay attention to point 1 of the reasons for recurrent attacks mentioned above, but not to points 2, 3, 4 and 5; some patients pay attention to points 1, 2, 3 and 4, but they are unwilling to check the blood uric acid because of the trouble, so taking medicine becomes a psychological comfort to themselves, not knowing that the blood uric acid does not come down, and they are still taking medicine every day or recurrent. To sum up, the main reason for recurrent gout is the above mentioned 5 points, gout treatment only around the 5th point in the lowering of uric acid target for all aspects of treatment adjustment, regular monitoring of blood uric acid, lowering uric acid treatment at the same time to uric acid uric acid down to how much to clear, only to achieve the goal of uric acid reduction, in order to avoid recurrent gout attacks for a long time.