Managing A Gout Flare

Content

• Who's At Risk?
• Gout Causes
• What Is Gout? Know The Signs And Risk Factors
• Chronic Tophaceous Gout

This condition is known as hyperuricemia, according to the NIH. While treating gout can be tricky due to the fact that it is usually not the only health issue that needs attention, the good news is that gout is one of the few types of arthritis that can be reversed. A holistic approach that takes into consideration a person’s diet, lifestyle, and other health problems is the best way to keep the intense pain of gout at bay. Acupuncture and TCM offer a solid alternative treatment method that can relieve gout and improve your overall health, all without unwanted side effects. TCM theory designates several internal pathogenic processes that can occur within the organ systems. TCM views gout as a problem of dampness and heat, and/or stagnation and buildup of phlegm in the joints.

What triggers gout?

Foods and drinks that often trigger gout attacks include organ meats, game meats, some types of fish, fruit juice, sugary sodas and alcohol. On the other hand, fruits, vegetables, whole grains, soy products and low-fat dairy products may help prevent gout attacks by lowering uric acid levels.

Gout attacks can happen over and over again in the same joint or affect different joints. Men can be three times more likely than women to get it because they have higher levels of uric acid most of their lives. But it’s also found in other joints, including the knee, ankle, foot, hand, wrist and elbow.

Who's At Risk?

Once you have been diagnosed with gout, oral medications are usually prescribed. Within a few days, most of the symptoms will significantly decrease. Some people experience a significant improvement within a few hours of treatment. Along with oral medications, you may be asked to change your diet to reduce your intake of foods with high purine levels to decrease your uric acid production. Gout is a type of inflammatory arthritis caused by a build up of crystalized uric acid in the joints and can be severely painful. It may develop in the ankles, knees, wrists, fingers, and elbows, but most commonly develops in the foot – specifically at the base of the big toe.

First-line treatment options are nonsteroidal anti-inflammatory drugs , glucocorticoids, and colchicine . The decision which of the 3 substance groups to use depends on the patient’s comorbidities and the physician’s experience. Proper treatment of acute attacks and lowering uric acid to a level less than 6 mg/dL allows people to live a normal life. However, the acute form of the disease may progress to chronic gout if the high uric acid is not treated adequately. To reduce the risk of a rebound flare, preventive treatment and initiation of a tapered course of corticosteroids over 10 to 14 days is recommended after resolution of symptoms. Gout Diet Foods Menu Whether you get gout can depend on your diet.

Gout Causes

See section 7 below for a discussion of agents presently under study for gout. Online resources, such as ClinicalTrails.gov, can help to identify clinical trials. More recent data has looked at ways to reduce the body forming antibodies to pegloticase.

Treatment for gout has nearly as long a history as the disease itself. Evidence exists that in ancient Greece that colchicine, a nitrogenous compound derived from the autumn crocus plant, was used as a strong laxative as a measure to combat a lifestyle of excess. However, its first use as a selective and specific treatment for gout is accredited to the Byzantine Christian physician Alexander of Tralles in the 6th century AD. Toward the end of the 19th century uricosuric agents were used for the first time. Nonsteroidal anti-inflammatories are most commonly the drugs of choice for treating acute gout in modern medicine. A key advance in the treatment of increased uric acid levels, was the development of xanthine oxidase inhibitors.

As the tophi become enlarged they may cause deformities, and there is potential for them to protrude through the skin and exude a white chalky substance . Some of the most common sites of enlarged tophi are the forearm, ear, knee and foot. Although colchicine was once the treatment of choice for acute gout, it is now less commonly used than NSAIDs because of its narrow therapeutic window and risk of toxicity. To be effective, colchicine therapy is ideally initiated within 36 hours of onset of the acute attack. When used for acute gout in classic hourly dosing regimens , colchicine causes adverse GI effects, particularly diarrhea and vomiting, in 80% of patients.

Many people who have gout also have heart problems or high blood pressure. This type of medical treatment for preventing and controlling gout often goes on for years, or even for the rest of a person’s life. Gout is a disease that results when crystals of uric acid form in tissues of the body.

Contacting A Doctor

Gout usually develops after a number of years of buildup of uric acid crystals in the joints and surrounding tissues. A gout attack usually starts during the night with moderate pain that grows worse. A gout attack typically causes pain, swelling, redness, and warmth in a single joint, most often the big toe.

Do not take aspirin with these drugs because it blocks their effects on the kidneys. Read the labels of any prescription or over-the-counter medicines you take to be sure they don't contain aspirin. Prevent or treat tophi--these medications include probenecid, sulfinpyrazone and allopurinol. If you experience sudden, intense pain in a joint, call a healthcare provider right away.

Another pain reliever commonly used to reduce gout pain is colchicine. It is most effective when taken within the first 12 hours of symptoms, according to NIAMS. Once the flare-up subsides, the doctor may prescribe low, daily doses of colchicine to ward off future attacks. While gout has painful and distinctive symptoms during flare-ups, its symptoms can be vague during other times. A doctor may extract a sample of joint fluid so it can be examined under a microscope for any presence of urate crystals, according to the NIAMS.

Drugs Used To Treat Gout

People who cannot take NSAIDS due to stomach ulcers or kidney problems are often given corticosteroid injections in the affected joint. Many patients are also prescribed a drug called colchicine, which works by disrupting a specific inflammatory response in the body, which can help to reduce the formation of uric acid crystals. The rate of colchicine side effects such as nausea, vomiting, diarrhea, and stomach pain is fairly high. A patient's history can provide the first clues to diagnosing an acute gout attack. He or she may have a personal or family track record of gout and acute attacks in the hospital. The medication history may signal red flags, as well, such as chronic gout therapy that was discontinued on admission.

Health

As the clincal features of acute gout and a septic joint can be very similar, arthrocentesis is important to rule out infection by sending the joint fluid for culture in these circumstances. Another effective way to reduce uric acid levels is to follow a low-purine diet. Purines are organic compounds that break down into uric acid. Following a low-purine diet means avoiding “the big four” — alcohol, shellfish, red meat, and high fructose corn syrup. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food , may help prevent future attacks. Changing or stopping medications associated with hyperuricemia may also help.

Treatment And Prevention Of Gout

The individual should be seen by a physician, in the emergency department, or urgent care center if the attack does not respond to this treatment. The individual may need regular medications to prevent further arthritis flares. With time, attacks of gouty arthritis can occur more frequently and may last longer. While the first attacks usually involve only one or two joints, multiple joints can be involved simultaneously over time.

These deposits can cause pain-often severe-and swelling in the affected area or areas. Gout, also called gouty arthritis, is a disease of how the body processes nutrients in which crystals of uric acid are deposited in the joints, tendons, and skin. Most commonly affecting men, gout emerges as the sudden development of swollen, red, hot, tender joints, especially at the big toe, ankle, wrist, and knee. As of 2020, allopurinol is generally the recommended preventative treatment if medications are used. A number of other medications may occasionally be considered to prevent further episodes of gout, including probenecid, febuxostat, benzbromarone, and colchicine. Long term medications are not recommended until a person has had two attacks of gout, unless destructive joint changes, tophi, or urate nephropathy exist.