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GOUT

Introduction

Anyone who has a sudden onset of a hot, red, swollen joint should seek medical care, either with a primary-care physician, at an emergency department, or with a rheumatologist (arthritis  specialist). These symptoms can also be due to an infection or loss of cartilage in the joint. It is important to make an accurate diagnosis of gouty arthritis as the treatment ultimately is guided by the cause of the inflammation.

If you have been diagnosed with gout and have more than one attack of arthritis, you should take the medication prescribed by your physician for these attacks. You should be seen by your physician or in the emergency department if your attack does not respond to this treatment. You may need medication to prevent further arthritis flares.

Attacks of abdominal pain due to kidney stones (renal colic) may also be related to gout.

Self-Care at Home

Take medication as prescribed.

While a joint is hot and swollen, you may want to use a cane or similar support to keep your weight off that joint.

It may be helpful to keep the swollen joint elevated above your chest as much as possible.

Ice packs can be helpful in relieving pain and reducing inflammation.

Maintaining adequate hydration is key for minimizing attacks.

Follow-up

It is critically important to follow up with your doctor. Gouty arthritis is treated in two stages. The first stage is to treat the acute arthritis. The second stage is to prevent gouty arthritis attacks from happening again. Low doses of colchicine may be started during an acute attack, but medication to lower the blood uric acid levels are avoided because this could intensify or prolong your attack. Therefore, you will need to follow up with your doctor after the acute attack has resolved to determine if it is necessary to start medication to lower the blood uric acid level.

Prevention

If you are at risk for gout, you should

A.   eat a low-cholesterol, low-fat diet. People with gout have a higher risk for heart disease. This diet would not only lower your risk for gout but also your risk for heart disease.

B.   slowly lose weight . This can lower your uric acid levels. Losing weight too rapidly can occasionally precipitate gout attacks.

C.   restrict your intake of alcohol, especially beer.

D.   stay hydrated.

E.   adjust your intake of dairy products, such as nonfat milk and yogurt, because they can lower the frequency of gout attacks.

If you have had an attack of gouty arthritis, you should do all of the above and follow the regimen prescribed by your physician. The adequate prevention of gouty arthritis may involve lifelong medical therapy.

Living with gout

Life style changes such as weight control, limiting alcohol consumption, and limiting meals with meats and fish rich in purines, are helpful in controlling gout

Lifestyle changes may make it easier to manage this lifetime disease. Suggestions include gradual weight loss, avoidance of alcohol and, in some cases, reduced consumption of foods high in purines like FISH & MEAT and carbohydrates.

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