Gout Attack Symptoms, Causes, Treatment And Diet

Content

• Treatment Overview
• Mywakehealth
• Prognosis Of Gout
• Gout With Tophus
• Leading A Gout Free Life
• What Can Trigger An Attack Of Gout?
• When Should I Call My Health Care Provider?

Also known as gouty arthritis, the disease is caused by the formation of uric acid crystals in a joint , triggering severe pain, redness, and swelling. When there is an overabundance of uric acid in the blood it is called gout. Usually, having too much uric acid in the blood is not harmful. In fact many people with high levels in their blood never know about it. When uric acid levels in the blood become extremely high, the uric acid may start to form crystals. These crystals most commonly form in the joints, especially the joints in the big toe.

Kidney disease can lead to gout, and gout may lead to kidney disease. If you have either condition, talk to your doctor about preventing the other. Oral corticosteroids, intravenous corticosteroids, NSAIDs, and colchicine are equally effective in treating acute flares of gout.20 NSAIDs are the first-line treatment. Indomethacin has historically been the preferred choice; however, there is no evidence it is more effective than any other NSAID.

Treatment Overview

Gout usually starts in the big toe but can affect other joints. Gout is a treatable condition, and the uric acid level can be decreased by medication and lifestyle changes. Talk to your healthcare provider about medications that can reduce uric acid levels.

Mywakehealth

When used as one or two tablets a day (0.6mg each), most people tolerate this medication well, and this dose can help prevent gout attacks. Some physicians would start colchicine after one very severe or two moderately severe attacks of gout, and beyond that, use allopurinol. If a patient has two attacks of gout within the same 12 months, it is generally recommended that they be treated with a medication to lower the uric acid, which colchicine does not accomplish. See below for discussion of the uric acid-lowering agents, allopurinol and probenecid. Colchicine also has a major role when patients are beginning therapy with allopurinol to prevent the increase in gout attacks that can happen when allopurinol is begun. The colchicine, in that case, is often withdrawn at about six months, assuming no gout attacks have occurred.

Can you eat cheese if you have gout?

Chocolate can lower uric acid crystallization, according to a 2018 study . Lowering uric acid crystallization can be key to controlling your gout. Chocolate has polyphenols associated with antioxidant and anti-inflammatory activities. Inflammation reduction is helpful in providing relief from a gout attack.

Your doctor may also prescribe corticosteroids for acute gout attacks. These are strong anti-inflammatory medications that can be taken either in pill form, intravenously, or injected into the painful joint. Cortisone may improve the severe inflammation very quickly. If your symptoms do not improve with initial treatments, your doctor may recommend a synovial fluid analysis. During this test, synovial fluid is drawn from your inflamed joint. When you have gout, there is more fluid in the joint and the fluid contains white blood cells.

Prognosis Of Gout

After gout flares have resolved, there are medications that can lower the level of uric acid over time in order to prevent or lessen attacks. When gout is mild, infrequent, and uncomplicated, it can be treated with diet and lifestyle changes. However, studies have shown that even the most rigorous diet does not lower the serum uric acid enough to control severe gout, and therefore medications are generally necessary. The treatment goals for a gout attack are different than those for chronic gout. When treating a gout attack, the goal is to relieve pain and inflammation. When treating chronic gout, the goal is to prevent future gout attacks and long-term joint damage.

However, in September 2020, The Lancet published the FAST trial, which is a European trial very similar to the CARES trial, found a different result. Here, there was no difference in death rates in patients on febuxostat compared to those on allopurinol. Some have called for the FDA to reconsider its recommendations, but no changes made to date. The FAST trial gives considerable comfort to those patients presently on febuxostat. It is generally agreed that we have no evidence that febuxostat is a negative for the heart, just the question of the CARES trial as to whether it is not as protective as allopurinol.

In patients prone to gout, eating meat, liver, shellfish, and drinking beer can lead to gout attacks. However, kidney disease in the primary reason most people have gout. Losing weight may help lower uric acid levels and reduce the risk that you will experience future gout attacks. Prompt diagnosis and treatment of gout can help control symptoms and reduce the risk of complications, such as disability. Seek prompt medical care if you have symptoms of gout, such as pain, redness, burning or swelling of a joint. While advanced gout can cause nodules under your skin on your feet, mild cases may not show physical symptoms.

All protein from animal flesh can potentially lead to elevated uric acid levels. The human body makes uric acid during the breakdown of chemicals called purines found in certain food and drinks. This normal byproduct goes through the kidneys and exits the body when you pee.

Gout is most commonly seen in men older than age 40, but it can strike anyone, especially postmenopausal women. Pacific Islanders are far more susceptible to gout compared to other ethnic groups. Gout is not curable, but it can be successfully managed with medical therapy and lifestyle changes. Its symptoms resemble those of several other diseases, disorders and conditions, such as psoriatic arthritis and pseudogout. An acute gout attack will generally reach its peak hours after onset, and then will slowly begin to resolve even without treatment. Full recovery from a gout attack takes approximately 7-14 days.

When To See A Doctor

The joint at the base of the big toe is the most common site of an acute gout attack. Over time, they can harm joints, tendons, and other tissues. Gout is a kind of arthritis caused by a buildup of uric acid crystals in the joints. Uric acid is a breakdown product of purines that are part of many foods we eat.