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Gout is often divided by experts into four symptomatic stages: asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout, and chronic tophaceous gout. Gout symptoms can be precipitated by stress, infection, joint injury, weight loss, surgery, certain kinds of drug treatment, overindulgence in alcohol or purine-rich foods, or even something as seemingly inconsequential as a long walk that one was not sufficiently physically fit to undertake. The tend to occur more in the spring than other seasons. Hospitalization and drug treatment are probably the most significant triggers, and in fact, 20% to 86% of those who have had gout experience a recurrence when they are hospitalized.

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