What To Do During An Attack
You should:
- take any medication you’ve been prescribed as early as possible after you notice an attack this should start to have an effect within two or three days
- rest and raise the limb
- avoid knocking or damaging the affected joint
- keep the joint cool remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel
- ensure you’re well hydrated
Apply the ice pack to your joint for around 20 minutes. Don’t apply ice directly to your skin and don’t apply it for more than 20 minutes at a time because this could damage the skin.
If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first.
Know Your Risk Factors
Gout flares, also known as attacks, are triggered by a buildup of uric acid. This chemical develops in the bloodstream when your body breaks down purines, natural substances in certain foods. Normal amounts of uric acid simply dissolve and move through your kidneys and into your urine. But when theres too much of it, uric acid crystals can form and accumulate in joints.
The exact cause of excess uric acid that leads to gout is an active area of research. Its believed to be a perfect storm of genetics, environmental exposures, and other health conditions, such as:
- Certain high blood pressure medications, such as diuretics
- Obesity
- A diet heavy in high-purine foods and beverages, such as alcohol, red meat, certain types of seafood and shellfish, and food and drinks sweetened with fructose
Estrogen appears to have a protective effect, so we rarely see gout flares in premenopausal women and most often see gout in middle-age and elderly men.
Gout isnt fully preventable, but you can reduce flares by modifying risk factors you can control, such as your diet and weight. Your doctor can help you make healthier lifestyle or medication changes to reduce your risk of gout.
Middle-age & elderly men are most likely to develop #gout, a common type of inflammatory #arthritis that can cause permanent #JointDamage if left untreated. Recognizing risk factors & symptoms are the first step in preventing it: https://bit.ly/3mufYnk.
How Will Gout Affect Me
Attacks can vary from person to person. Some people only have an attack every few years, while others have attacks every few months.
Without medication attacks tend to happen more often and other joints can become affected.
Having high urate levels and gout for a long time can lead to other health problems, including:
- narrowing of the arteries – which can lead to an increased risk of stroke or heart attacks or other heart problems
- osteoarthritis, which occurs when the urate crystals and hard tophi cause joint damage.
- an increased risk of developing kidney disease or worsening of the condition if you already have it
- kidney stones
- an increased risk of some cancers, especially prostate cancer
- mental health problems, including depression
- underactive thyroid
- erectile dysfunction in men.
If you take medication to lower your urate levels, and have a healthy diet and lifestyle, most of the damage and complications caused by gout can be stopped.
Treatments for gout are incredibly successful. There are two main parts to treating gout, which are:
- treating the acute attack
- treatments to prevent future attacks.
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When Asked How Long Does Gout Last Most People Would Say A Few Days To A Few Weeks
How long does gout last? Your symptoms, treatment, and diet all come into play.
A gout attack can cause sudden and very severe joint pain. It frequently starts in the joint of a big toe and may wake you up at night. Even having a sheet resting on your toe can be painful. A gout attack can make you miserable. It may last from three days to up to two weeks. Taking medication usually helps reduce the pain and may shorten the attack. But even without medication, a gout attack usually goes away within ten days.
Once you have had an attack of gout, you need to start treatment to prevent another attack, because gout often comes back. Without treatment, you can expect another attack within two years. People with frequent attacks can develop a type of long-term gout that does not go away. It can cause painful lumps in or near joints and can cause damaging deformity of a joint. The good news is that treatment works well. Gout is very controllable for most people.
Stage : Intercritical Gout
After a first gout flare, 75 percent of people will have a second within a year but some people can go years before another attack, says Dr. Fields. The in-between stage is where a person has already had a gout flare but is presently not having any joint pain or swelling, he says. Almost all gout patients will go through this phase, since it is the nature of gout to have flares and then quiet down for a period of time before the next flare.
Even though it may seem like nothing is happening, this is the point in which patients should begin long-term treatment. Lowering uric acid levels with medication can prevent future gout flares and long-term complications that go with them.
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How Is Gout Treated
Gout can be effectively treated and managed with medical treatment and self-management strategies. Your health care provider may recommend a medical treatment plan to
- Manage the pain of a flare. Treatment for flares consists of nonsteroidal anti-inflammatory drugs like ibuprofen, steroids, and the anti-inflammatory drug colchicine.
- Prevent future flares. 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.
- Prevent tophi and kidney stones from forming as a result of chronic high levels of uric acid. Tophi are hard, uric acid deposits under the skin. For people with frequent acute flares or chronic gout, doctors may recommend preventive therapy to lower uric acid levels in the blood using drugs like allopurinol, febuxostat, and pegloticase.
In addition to medical treatment, you can manage your gout with self-management strategies. Self-management is what you do day to day to manage your condition and stay healthy, like making healthy lifestyle choices. The self-management strategies described below are proven to reduce pain and disability, so you can pursue the activities important to you.
What To Do For A Gout Attack
Medication may shorten a gout attack. Your doctor may prescribe medication that blocks inflammation called a nonsteroidal anti-inflammatory drug , you may also take a drug called colchicine or a strong anti-inflammatory steroid drug. Over-the-counter NSAIDs include ibuprofen and naproxen.
These drugs will reduce the pain and inflammation, but there are also home treatments that will help. Home treatment includes resting your joint, elevating your joint above the level of your heart, and using ice packs to reduce pain and swelling.
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What Foods Are High In Purines And Why Should I Avoid Them
In your body, uric acid is made from the breakdown of chemicals called purines, which come from the foods we eat. Some foods have more purines than others. It’s important to eat a balanced diet and include a variety of healthy foods in your diet, but to avoid eating too many foods that are high in purines. Eating these foods can trigger an attack of gout.
Examples of foods that have high purine content are:
- seafood, such as mussels and other shellfish, crab, fish roe, whitebait and trout
- game such as venison and rabbit
- offal such as liver, kidneys, heart and sweetbreads
- meat and yeast extracts such as Marmite, Bovril and commercial gravy.
A number of vegetables such as such as asparagus, mushrooms, cauliflower and spinach are also rich in purines, but these appear less likely to trigger gout than shellfish and game meats.Most people taking medicines to reduce uric acid levels find they can still eat purine-rich foods without attacks of gout by being careful with how much they eat.
Can Gout Be Cured
Cure is a very strong word, but we can certainly treat the gout and put it in remission by giving the treatment as mentioned, Dr. Meysami says.
Whether to use the word cure may be a matter of semantics: A patients gout tendency may never go away but can be well-controlled. Treatments for gout are extremely good, and the vast majority of gout patients can expect to be cured, Dr. Fields says. Cured is in quotes since it means that gout flares can completely disappear, but the person would need to stay on their medicine.
Gout progression, though, certainly isnt inevitable, which is close to the best news any gout patient can hear.
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Treatment For Gout And Gout Attacks
As soon as youve been diagnosed with gout, your doctor will aim to reduce your pain ASAP. In May 2020, the American College of Rheumatology updated its guidelines for gout treatment for the first time in eight years. There is more evidence in support of early diagnosis and treatment treat-to-target protocols and allopurinol as a first-line agent.
Lessen Your Risk Of Early Death
On average, having gout raises a persons risk of dying earlier than a similar person without gout by 25 percent. To lessen that risk, gout patients need to work with their doctor to lower uric acid levels to the target of < 6 mg/dl and keep it there throughout life, Dr. Edwards says. In addition, people with gout need to control medical conditions that go along with gout , such as hypertension, heart disease and kidney disease.
So if you have gout, heres what you need to do to ensure you live the longest, healthiest life you can:
- Take your gout medications and other medications as directed
- Get screened and treated for comorbid conditions
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Tips For Avoiding A Gout Flare
Gout is a form of arthritis that usually affects the joint between your foot and your big toe. Its caused when theres a buildup of uric acid in your bloodstream, and the acid crystallizes. The crystals tend to form around that particular joint because its far from your heart, so your circulation may not be as strong there as in other parts of your body.
The uric acid crystals cause inflammation that can ultimately lead to joint damage and pain. Gout can be debilitating, but there are some things you can do to avoid the pain of a gout attack.
Dr. Michael Tran and the staff at AllCare Foot & Ankle Center present these five tips for avoiding gout flare-ups. Youll likely still need medication, but these lifestyle changes can also be an important part of your treatment plan.
Who Gets Gout Gout Risk Factors
Gout happens when too much uric acid builds up in the body. Uric acid is a normal waste product in the blood resulting from the breakdown of certain foods. Uric acid usually passes through the kidneys and is eliminated from the body in urine. But it can build up in the blood and form painful, spiky crystals in your joints. This may happen if the body is making too much uric acid or if the kidneys are having a hard time filtering it out.
Having too much uric acid in the blood is a condition called hyperuricemia. Certain foods, medicines, and lifestyle factors can cause high uric acid levels in the blood, triggering a gout attack.
Your risk of gout goes up when your diet is high in naturally occurring compounds called purines. When purines break down in the body, they cause uric acid to form. Purines are found in certain high-protein foods and some drinks. It used to be thought that gout was caused only by lifestyle and diet, but new research has found that’s not true instead, gout is thought to have a genetic link. Diet, however, does play a role in the disease.
Other risk factors for gout include:
- Being a man
- Type 2 diabetes
- Health conditions that cause rapid turnover of cells
- KelleySeegmiller syndrome or LeschNyhan syndrome
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Fact: Dairy Products Can Help Lower Uric Acid Levels
Where the misconception stems from is unclear, but what we do know is that people with gout do not need to avoid all dairy foods, as they are low in purines, according to Dr. Prest. Additionally, studies have shown that consuming low-fat milk, yogurt, and other dairy products reduces uric acid production and increases uric acid excretion from the body. For example, a 2011 study published in the journal Current Rheumatology Reports found that, low-fat dairy intake has a moderate urate-lowering effect.
The Four Stages Of Gout
Gout is best understood by seeing it as having four phases or stages :
Stage 1: High uric acid
Elevated uric acid without gout or kidney stone, this stage has no symptoms and is generally not treated.
Stage 2: Acute flares
This stage is marked by acute gout attacks causing pain and inflammation in one or more joints.
Stage 3: Intercritical periods
These are periods of time between acute attacks, during which a person feels normal but is at risk for recurrence of acute attacks.
Stage 4: Advanced gout
This is a stage of chronic gouty arthritis, in which there are lumps of uric acid, or tophi , frequent attacks of acute gout, and often a degree of pain even between attacks .
Figure 1: Stages of Gout
Figure 2: Illustration of Toe Joint with Gouty Tophus. normal toe joint Urate crystals, shown in white, at the “bunion joint,” represent a gouty tophus.)
Figure 3: Progression of Gout
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Avoid Sweetened Foods And Drinks
Foods and drinks sweetened with artificial fructose increase the risk of getting gout. These are contained in fizzy drinks and fruit drinks and are usually seen on food labels as corn syrup or glucose-fructose syrup. Other examples of foods sweetened with fructose are bread, cereal and jam. Fructose is found occurs naturally fruit and vegetables. Do not completely avoid these without advice from your doctor or dietitian.
Whats The Outlook For People With Gout
Untreated gout can lead to permanent joint damage. The buildup of uric acid in the joints and soft tissue is called tophus. Some people with gout can also develop other health problems, such as severe arthritis, kidney stones and heart disease. Its important to discuss your symptoms with a healthcare provider.
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Other Symptoms Of Acute Gout Or A Gout Attack
- Sudden crushing or throbbing pain in one or a few joints that may last for a few days
- Sometimes an acute gouty arthritis attack has a sudden onset at nighttime. The big toe joint pain may be so severe that even the weight of bedsheets causes discomfort.
- Joints that appear swollen and inflamed, with reddish-purple skin that may feel warm
What Happens If Gout Is Left Untreated
If gout is not treated, it can cause permanent damage to your joints and harm your kidneys. Attacks will happen again and more joints will be affected. Lumps can grow on your elbows, hands and feet. The lumps can become sore and swollen and they may cause skin ulcers. The natural padding between the bones will start to wear away and the joints will become sore and stiff. Kidney stones can form and cause pain and damage to your kidneys.
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Signs And Symptoms Of Gout
Any joint can be affected by gout, but it usually affects joints towards the ends of the limbs, such as the toes, ankles, knees and fingers.
Signs and symptoms of gout include:
- severe pain in one or more joints
- the joint feeling hot and very tender
- swelling in and around the affected joint
- red, shiny skin over the affected joint
Symptoms develop rapidly over a few hours and typically last three to 10 days. After this time the pain should pass and the joint should return to normal.
Almost everyone with gout will experience further attacks at some point, usually within a year.
Read more about the complications of gout.
Can You Drop 8 Pounds Weight Loss Helps Prevent Gout
If youre overweight, you are likely to have higher-than-normal uric acid levels, a primary risk factor for developing gout. Thats why weight loss is an important part of a gout diet.
Losing weight may help lower uric acid levels and reduce the risk that you will experience future gout attacks. In fact, a weight loss of about eight pounds or more led to long-term reductions in uric acid levels and gout attacks in overweight or obese people, according to a review of studies published in 2017 in the Annals of the Rheumatic Diseases.
While some people with gout benefit from cutting back on foods that are high in purine, a chemical that contributes to uric acid formation, it is not clear how much purine intake makes a difference. You dont have to avoid all high-purine foods. Moderate changes to your eating style may help you feel better and reduce gout risks, and research suggests that purine-rich vegetables dont trigger gout. High-purine foods such as lentils and beans can be a smart source of lean protein.
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Gout Nicola Dalbeth Goodfellow Unit Nz 2017
“Professor Nicola Dalbeth shares an update on the management of gout. Nicola is a rheumatologist at the University of Auckland and Auckland District Health Board. She is a founding member of the Mori Gout Action Group, chair of the Atlas of Health Care Variance Gout Expert Advisory Group and was clinical lead advisor for the gout clinical pathways and bpac gout treatment guidelines.”