Gout or "gouty arthritis" is an inflammation of a joint due to a build-up of gout crystals in the joint fluid. This occurs when there is an excess uric acid (a normal waste product) in the body. Uric acid builds up in the body when the kidneys are unable to filter enough of it from the blood. This may occur with aging or kidney disease. Gout occurs more often in persons with obesity, diabetes, hypertension, high fats in the blood. It may be present in other family members. Alcohol and certain foods (such as shellfish and alcohol) may increase uric acid levels in the blood and cause a gout attack.
Gout causes a hot, red, swollen and painful joint. If you have had one episode of gout, you are likely to have another. An acute attack of gout can be treated with anti-inflammatory and other medicine. If these attacks become frequent it may be necessary to take a daily medicine to help the kidney remove uric acid from the body.
1. Apply an ice pack (ice cubes in a plastic bag, wrapped in a towel) over the area for 20
minutes every 1-2 hours the first day for pain relief. Continue this 3-4 times a day until the pain and swelling goes away.
2. Avoid alcohol and foods listed below (see Prevention) during a gout attack. Drink extra
fluid to help flush the uric acid through your kidneys.
3. Rest painful joints. If gout affects the joints of your foot or leg, you may want to use
crutches for the first few days to keep from bearing weight on the foot or leg.
4. Take anti-inflammatory medicine as directed. You may be prescribed Indocin
(indomethacin), or over-the-counter drugs such as ibuprofen (Motrin, Advil) or naproxen (Naprosyn or Aleve). Tylenol will not be as effective since it is not an anti-inflammatory drug.
5. If narcotic pain medicines are prescribed, they should be used in addition to the anti-
inflammatory drugs and only for severe pain. Avoid aspirin since this may slow down the flushing of the uric acid through your kidneys.
PREVENTING FUTURE ATTACKS:
Minimize or avoid alcohol use. Excess alcohol intake can cause a gout attack.
Foods high in purine form uric acid in the body and increase your risk for a gout attack. Therefore, avoid the following foods: certain seafoods (anchovies, sardines, shrimp, scallops, herring, mackerel); wild game, meat extracts and meat gravies; organ foods (kidney, liver, calf brain, sweetbreads). Avoid drinks with fructose (a type of sugar).
Limit the following foods to one serving a day: red meat and pork, fish, poultry, dried beans and peas, asparagus, mushrooms, cauliflower and spinach.
If you are overweight, this is a risk factor and you should talk to your doctor about a weight reduction plan. However, avoid fasting or extreme low calorie diets (less than 900 cal/day) which will increase uric acid levels in the body.
If you are diabetic or have high blood pressure, work with your doctor to achieve control of these conditions.
Avoid injury to the involved joint since this can lead to a gout attack.
Colchicine can be effective in stopping a gout attack. If you were given a prescription of this medicine for future use, begin it at the first sign of an attack. Colchicine may cause nausea, vomiting, diarrhea and other side effects.
FOLLOW UP with your doctor as advised or if you are not improving after three days of treatment. GET PROMPT MEDICAL ATTENTION if any of the following occur:
Fever over 100.4ºF (38.0ºC) with worsening joint pain
Repeated vomiting, abdominal pain, or blood in the vomit or stool (black or red color)
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