Gout can move through several phases. Hyperuricemia is the first; some people with increased uric acid levels may not have symptoms. As the uric acid crystals accumulate, the person can experience gout flares, which are periods of intense pain and swelling. Between flares are intercritical or interval gout, symptom-free periods between attacks.
Late-stage gout can also cause tophi, which is when crystals build up in the skin or other areas of the body. Depending on their location, tophi can permanently damage the joints and internal organs.

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