Managing Gout

Content

• Treating Gout With Medications
• Find A Gout Specialist
• Gout And Hyperuricemia

If you are suffering from any of these symptoms, you should schedule an appointment with one of our podiatrists as soon as possible for a full diagnosis and treatment. Our podiatrists will give you a diagnosis based off of a full foot examination, your medical history, and possibly X-rays and laboratory blood tests if needed. A blood test can measure the level of uric acid in your blood. It may wake you up at night with intense pain in your big toe — so intense that you cannot stand to have it touched, even by the sheets. Treatment of gout can be difficult because of coexisting illnesses and other medications. What works well for one person may not work as well for another.

The intense pain that is experienced in the midst of an attack is often preceded by burning, itching, or tingling in the affected joint. These signs can begin one to two hours before an attack. Once you have experienced these symptoms once, you can begin to predict recurrent attacks and start treatment as soon as the signs appear. However, it is not uncommon to have no precursor signs and some individuals are struck with an attack seemingly out of the blue, especially when attacks are infrequent.

Treating Gout With Medications

Often, the first symptoms of a gout attack are sudden pain and swelling in one of your joints. The joint most often affected is the big toe, but gout can happen in any joint . Other medications such as probenecid and allopurinol , are used for managing the underlying metabolic derangement that causes hyperuricemia and gout.

How long does it take to trigger gout?

Uric acid is a waste product made by the body when it digests certain foods. When uric acid levels are high, crystals of it can accumulate in your joints. This process triggers swelling, inflammation and intense pain ( 5 ). Gout attacks typically occur at night and last 3–10 days (6).

Cleveland Clinic offers expert diagnosis, treatment and rehabilitation for bone, joint or connective tissue disorders and rheumatic and immunologic diseases. If you experience sudden, intense pain in a joint, call a healthcare provider right away. If the joint is hot and inflamed, you might have gout — or you might have another problem like an infection. In a typical presentation, gout affects the metatarsal-phalangeal joint at the base of the big toe and causes a lump that looks similar to a bunion but is bright red and warm. While a mild fever can accompany a gout attack, a high fever (over 100.4 degrees F) may be a sign of an infection.

Find A Gout Specialist

Pounding on an inflamed gouty joint can prolong the flare. It’s fine to do other kinds of exercise, for example any exercise involving the upper body, but give the gouty joint a rest. This is another reason to treat gout flares quickly, since starting early often means the flare will be short – and you can limit your time off your feet. In the past, high doses of colchicine were used for gout attacks, but this tended to cause diarrhea in a large number of patients. It has been shown that lower doses of colchicine are as effective as high doses for an attack of gout, and much better tolerated.

People with kidney and liver problems should talk with their health care professional before taking colchicine. The fluid withdrawn by an arthrocentesis is analyzed in a lab under a microscope for the presence of uric acid crystals. The fluid analysis can also rule out other causes of inflammation including bacterial infections. The large joint at the base of the big toe is the most common site for a gout attack but other joints commonly affected are the ankles, knees, wrists, fingers, and elbows. The large joint at the base of the big toe is the most common site for a gout attack, however, any other joint can be affected.

A Podiatrist should properly diagnosed ypur gout before you administer any treatment at all! Be aware that these supplements may be well rated, but they do lack overall deep scientific evidence. If your doctor has diagnosed you with gout and given you medication for a flare-up, take the medication as directed when you know you are having an attack.

Blood Test

Gout flares often can occur when you first start to use medications that lower blood uric acid levels. Patients can help prevent flares when starting these medications by also using low‐dose colchicine or NSAIDs. Often, doctors advise patients to keep taking colchicine in a low, preventive dose together with the uric acid-lowering medicine for at least six months. This medicine can be effective if given early in the attack.

However, tophi can be a valuable clue for the diagnosis as the crystals that form them can be removed with a small needle for diagnosis by microscopic examination. Microscopic evaluation of a tophus reveals uric acid crystals. Over time, the uric acid crystals and inflammation associated with gout can lead to vision complications. They can include tophi in the eyelids, cornea, and iris; dry eye syndrome; uveitis; glaucoma; and cataracts, which cloud the lens of the eye and impair vision. Long-term medicine treatment depends on how high your uric acid levels are and how likely other gout attacks are.

The treatment needs to be tailored for each person and may have to be changed from time to time. People who have hyperuricemia, but no other problems, usually do not require medications. A period of time when there are no symptoms at all, followed by other acute severe attacks. A sudden onset of joint pain and swelling that goes away after five to 10 days . Some people have one episode and never have any other problems with it.

Diagnosing Gout: Joint Fluid Analysis

Researchers have found dozens of genes that increase people’s susceptibility to gout, including SLC2A9 and ABCG2. Genes associated with gout affect the amount of uric acid the body holds onto and releases. Hard deposits, called tophi, can build up on your joints and in other places, like your ear. These lumps may be painful and swollen, and they can permanently damage your joints. But after many years, this condition can damage the joints, tear the tendons, and cause infections in the skin over the joints. Gout is a general term for a variety of conditions caused by a buildup of uric acid.