Gout results when the body is unable to get rid of a natural substance called uric acid. The uric acid forms needle-like crystals in the joint that cause severe pain and swelling. Gout usually affects big toes, knees, and wrists. More men than women have gout. Treatments include anti-inflammatory and special gout drugs, and sometimes a diet low in purines. Foods such as organ meats, beer, wine, and certain types of fish contain high levels of purines.