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Some medicines, such as water pills (diuretics), can also bring on gout. The most common sign of gout is a nighttime attack of swelling, tenderness, redness, and sharp pain in your big toe. You can also get gout attacks in your foot, ankle, or knees, or other joints. The attacks can last a few days or many weeks before the pain goes away.
Not long after these warning signals, the telltale signs of gout begin. If you get repeated gout attacks, you'll learn your body's signals that a gout flare-up is about to begin. Sometimes, people with gout have no early signs that a gout flare is about to start. They may wake up in the middle of the night with a very painful joint.