The Role Of Diet In Gout Prevention
Dietary control may be sufficient in a patient with mildly elevated uric acid, for example, 7.0 mg/dL
For those with a higher level, for example, 10.0 mg/dL, diet alone will not usually prevent gout. For the latter, even a very strict diet only reduces the blood uric acid by about 1 mg/dL- not enough, in general, to keep uric acid from precipitating in the joints. The cutoff where patients with gout seem to dramatically reduce their number of attacks is when their uric acid level is taken below 6.0 mg/dL.4
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Patients With Gout Need To Stay Active To Maintain Cardiovascular Health And Protect Joints From Long
Should I walk or engage in any exercise when I have gout? Many people with gout ask themselves this question. And the answer is yes except during a painful gout flare, according to Maura Daly Iversen, PT, MPH, DPT, SD, FAPTA, a physical therapist and behavioral scientist/clinical epidemiologist with a primary focus in rheumatology and Dean of the College of Health Professions at Sacred Heart University in Fairfield, Connecticut.
When in a gout flare, even the pressure of a bed sheet can be extremely painful, Dr. Iversen says. Most patients feel better by elevating their feet and resting and thats okay.
Is This Information Right For Me
This information is right for you if:
- Your health care professional* has said that you have gout.
- You are age 18 or older. This information is from research on adults.
* Your health care professional may include your primary care doctor, nurse practitioner, physician assistant, rheumatologist , orthopedist , or emergency room doctor.
This summary will answer these questions:
- What is gout?
- How is a gout attack treated?
- What have researchers found about medicines to treat a gout attack?
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What Are The Side Effects Of Allopurinol
Stop using this medicine and get emergency medical help if you have signs of an allergic reaction or a severe skin reaction .
Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.
Stop using allopurinol and call your doctor at once if you have:
- any skin rash, no matter how mild
- painful urination, blood in the urine
- little or no urination
- numbness, tingling, burning pain
- worsening gout symptoms or
- liver problems–loss of appetite, weight loss, stomach pain , itching, dark urine, clay-colored stools, jaundice .
Common side effects may include:
- an increase in gout attacks when you first starting taking allopurinol oral
- nausea, diarrhea or
- joint pain.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
How Can I Manage My Gout And Improve My Quality Of Life
Gout affects many aspects of daily living, including work and leisure activities. Fortunately, there are many low-cost self-management strategies that are proven to improve the quality of life of people with gout.
For gout in particular:
- Eat a healthy diet. Avoid foods that may trigger a gout flare, including foods high in purines , and limit alcohol intake .
CDCs Arthritis Program recommends five self-management strategies for managing arthritis and its symptoms. These can help with gout as well.
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What Is The Fastest Way To Get Rid Of Gout
- Nonsteroidal anti-inflammatory drugs : These can quickly relieve the pain and swelling of an acute gout episode. They can shorten the attack, especially if taken in the first 24 hours.
- Corticosteroids: These drugs can be taken by mouth or injected into an inflamed joint to quickly relieve the pain and swelling of an acute attack. Corticosteroids usually start working within 24 hours after they are taken.
- Colchicine: An anti-inflammatory medicine that works best if taken within the first 24 hours of a gout attack.
Medications for reducing uric acid levels: These are usually prescribed after an acute attack ends to reduce uric acid levels in the body to prevent future attacks.
- Colchicine: Regular and low doses of colchicine may be given along with other medications below to prevent flare-ups.
- Allopurinol: It reduces uric acid production in the body.
- : It reduces uric acid production in the body.
- Probenecid: It acts on the kidneys to help eliminate uric acid.
- Pegloticase: This is a medication that is injected every 2 weeks. It reduces uric acid quickly and used when other medications fail.
Lifestyle and home remedies to treat acute gout and can prevent recurrent attacks:
- Limiting or avoiding alcohol consumption and drinks sweetened with fructose
- Limiting intake of foods high in purines, such as red meat, organ meats, and seafood
- Drinking plenty of fluids
Home Remedies To Relieve Gout Pain
Gout is a metabolic disease caused by excess uric acid in the blood, which often causes swelling, inflammation, a burning feeling and intense pain crisis. This usually affects the joints, occurring most often in the feet and knees. In addition to timely medical treatment it is possible to reduce severe pain experienced in gout attacks with some natural products. If you need to find effective solutions, do not miss the following OneHowTo article on home remedies to relieve gout pain.
When facing a gout attack in which pain in the affected joint is very intense, bicarbonate of soda can be an excellent home remedy for relief. This is a product which favours the dissolution of crystals of uric acid, prevents fluid retention and decreases the specific ailments of this condition. Just add half a teaspoon of bicarbonate soda in a glass of water, mix well and drink before bedtime. Youll see how the symptoms of gout slow down.
Cold to the area
Applying cold to the affected limb is a good home remedy to relieve gout pain as it is perfect for reducing inflammation and swelling. Place an ice pack or cold compress directly on the joint for 15 minutes approximately.
Lavender essential oil
Changes in the diet
Also, there are other foods you can eat if you have gout that will help your condition and reduce its symptoms.
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Southern Cross Medical Library
The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
How Does A Doctor Diagnose Gout
If you have sudden or severe pain in a joint, you should talk to your primary care provider . Your PCP may send you to a rheumatologist, a doctor who specializes in gout and other kinds of arthritis.
Healthcare providers consider several things when confirming gout:
- Symptoms: The provider will ask you to describe your symptoms, how often they happen and how long they last.
- Physical examination: Your provider will examine the affected joint to look for swelling, redness and warmth.
- Blood work: A test can measure the amount of uric acid in your blood.
- Imaging tests: You may have pictures taken of the affected joint with X-rays, an ultrasound or MRI.
- Aspiration: The provider may use a needle to pull fluid from the joint. Using a microscope, a team member can look for uric acid crystals or a different problem .
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How Much Alcohol Can People With Gout Drink
Each gout patient is different, so its hard to determine what the safe limit for alcohol is. Its best to monitor your alcohol consumption and limit yourself to amounts that work best for you.
Lifestyle is an important factor for living with gout along with diet, medical condition, family history, age, and sex. If you find that beer is a common trigger for you, consider lowering your dose to minimize instances of gout attacks.
If taking alcohol out of your lifestyle is not an option, you should still lower it to avoid those crippling gout attacks. Thankfully, there are medications now that can help prevent and treat gout symptoms. Aside from maintaining a rigid diet low in purines, you should also be taking gout medications such as allopurinol.
Make sure to speak with your doctor about taking medications while drinking alcohol.
There is no hard evidence to prove that alcohol reduces the efficacy of allopurinol, but its still best to get the proper dosage to help you achieve low enough uric acid levels. If you still cannot lower your uric acid levels, then you may need to make drastic lifestyle changes such as cutting out alcohol altogether.
During a gout flare up, you should be avoiding alcohol as it could make it worse. Your gout is already experiencing a buildup of uric acid crystals. By drinking alcohol, you are only adding to the buildup and overworking your kidneys resulting in kidney stones and lumps under the skin.
Warning Signs Of A Gout Flare
Some people with gout, also known as gouty arthritis, say an attack begins with a burning, itching, or tingling feeling in a joint maybe an hour or two before the flare-up starts. The joint may feel a little stiff or a bit sore. Not long after, the telltale signs of gout begin. If you get repeated attacks, you’ll learn your body’s signals that one is about to begin.
Sometimes, people with gout have no early signs that a flare is about to start. They may just wake up in the middle of the night with a very painful joint.
When the flare starts, most people have redness, swelling, and severe pain, usually in one joint. The most common place for gout is the base of the big toe, but it can happen in other joints such as the elbow, knee, wrist, ankle, and instep.
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Where Does A Gout Attack Occur
Gout often attacks the largest joint in your big toe. However, it can also attack the foot, ankle knees, hands, or wrists. Intense pain, redness, and swelling can start with no warning, although you may have warning signs of an impending attack. If you start to feel tingling, burning, or itching in a joint, your body is giving you a warning signal that a flare-up is imminent.
How To Take Allopurinol
Use Allopurinol exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Allopurinol oral is taken by mouth.
Take allopurinol oral with a full glass of water. To reduce your risk of kidney stones forming, drink 8 to 10 full glasses of fluid every day, unless your doctor tells you otherwise.
Take allopurinol oral after a meal if allopurinol upsets your stomach.
Allopurinol injection is given as an infusion into a vein if you are unable to take the medicine by mouth. A healthcare provider will give your first dose and may teach you how to properly use the medication by yourself.
You may need to mix allopurinol injection with a liquid in an IV bag. When using injections by yourself, be sure you understand how to properly mix and store the medicine. Ask your doctor or pharmacist if you don’t understand all instructions.
Prepare an injection only when you are ready to give it. Do not use if the medicine has changed colors or has particles in it. Call your pharmacist for new medicine.
You may need frequent medical tests. Even if you have no symptoms, tests can help your doctor determine if this medicine is effective.
Store at room temperature away from moisture and heat.
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When Is Surgery Considered For Gout
The question of surgery for gout most commonly comes up when a patient has a large clump of urate crystals , which is causing problems. This may be if the tophus is on the bottom of the foot, and the person has difficulty walking on it, or on the side of the foot making it hard to wear shoes. An especially difficult problem is when the urate crystals inside the tophus break out to the skin surface. This then can allow bacteria a point of entry, which can lead to infection, which could even track back to the bone. Whenever possible, however, we try to avoid surgery to remove tophi. The problem is that the crystals are often extensive, and track back to the bone, so there is not a good healing surface once the tophus is removed. In some rare cases, such as when a tophus is infected or when its location is causing major disability, surgical removal may be considered.
Since it is hard to heal the skin after a tophus is removed, a skin graft may be needed. For this reason, we often try hard to manage the tophus medically. If we give high doses of medication to lower the urate level, such as allopurinol, over time the tophus will gradually reabsorb. In severe cases, we may consider using the intravenous medication pegloticase , since it lowers the urate level the most dramatically, and can lead to the fastest shrinkage of the tophus.
Important Information About All Medicines
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
If you buy any medicines over-the-counter, always check with a pharmacist that they are suitable for you to take alongside your other medicines.
If you are having an operation or any dental treatment, tell the person carrying out the treatment which medicines you are taking.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
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When To Get Help For A Gout Flare
It’s always a good idea to let your doctor know that you are having a flare. Sometimes, you may need to follow up to make sure your treatment plan is working or if your symptoms don’t improve. Call your doctor if:
This is your first flare-up. There are several other conditions, such as a joint infection, that have some of the same symptoms as gout attacks.
You have a highfever and chills. Gout attack symptoms may include a mild fever, but a higher temperature may be a sign of an infection.
Your symptoms don’t get any better after 48 hours or don’t end after about a week. If you don’t start to feel somewhat better after a few days, call your doctor. They may suggest a different treatment. Most gout attacks will go away by themselves in several weeks, even without treatment.
Rebecca Manno, MD, MHS, assistant professor of medicine, division of rheumatology, Johns Hopkins University School of Medicine.
Robert T. Keenan, MD, MPH, assistant professor of medicine, division of rheumatology and immunology, Duke University School of Medicine.
Scott Zashin, MD, clinical professor of medicine, University of Texas Southwestern Medical School attending physician, Presbyterian Hospital.
Lan Chen, MD, PhD, attending rheumatologist, Penn Presbyterian Medical Center.
Gout and Pseudogout Treatment & Management: “Treatment.”
Johns Hopkins Arthritis Center: “Gout — Treatments for Gout.”
Merck Manual: “Gout.”
The Excruciating Pain And Swelling During A Gout Flare Is Pretty Hard To Ignore
Whether youve been plagued by gout in the past or have never experienced it before, chances are that when a gout flare strikes youll quickly know something is very, very wrong: The excruciating pain and swelling, which often occurs in a single joint , is pretty hard to ignore.
If youve never had a gout attack and are thinking that people with gout must be exaggerating, consider this: 37 percent of people with gout said that theyd willingly give up a winning lottery ticket if they never had to experience a gout flare again, according to a patient survey.
Of course, making that sort of trade-off isnt an option. So what real-life choices do you have? Your best bet is to call your doctor stat. As soon as you feel a twinge, you need to get medical attention, says Joseph Huffstutter, MD, a rheumatologist with Arthritis Associates in Hixson, Tennessee. The sooner you treat a gout attack, the easier it will be to treat.
Heres a look at why gout flares happen and how to rein in the pain as quickly as possible.
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