: Getting Gout to Go Away
What you should know:
The pain caused by the disease of gout can be relieved with the
right treatment, careful nutrition, weight loss and fluids.
Pain occurs when sharp uric acid crystals form in one or more
joints. Uric acid is a body waste product that is passed through the
kidneys into the urine. Crystals can occur in joints because the
body makes too much uric acid or builds up too much uric acid rather
than getting rid of it.
Lower joints such as a big toe, ankle or knee are most often
affected. Gout is more common among overweight adult men and older
women. Gout seems to run in some families.
Discomfort often starts at night. Anything touching the irritated
joint - even a sock or sheet - can cause extreme pain. The joint can
become swollen and warm.
An acute gout attack might last only a few days. However, without
proper treatment, an acute attack can cause permanent joint damage.
Permanent joint damage can lead to chronic attacks.
A doctor who specializes in arthritis (rheumatologist) can
perform tests to diagnose whether you have gout. Diagnosis can
involve testing a sample of joint fluid for crystals and white blood
cells. Joints might be X-rayed and blood tests done to check the
blood's uric acid level.
The doctor can recommend the correct dose of a nonsteroidal anti-
inflammatory drug (NSAID) to reduce pain and swelling. He or she
might also prescribe a painkiller such as codeine and medicine like
colchicine to reduce swelling. The swollen joint can also be treated
with an injected steroid.
For chronic gout, the doctor might prescribe a medicine to reduce
uric acid in the blood, such as allopurinol.
Gout treatment might also require changes in lifestyle.
Sometimes pseudogout is confused with gout or some other form of
arthritis. In pseudogout, a type of salt crystal (calcium
pyrophosphate dehydrate), not uric acid crystals, forms in the
painful, swollen joint.
Many of the same medicines used for treating gout are generally
effective for pseudogout. Treatment for both diseases might include
removing excess fluid from a joint.
Other health conditions and medications increase the risk of a
gout attack or make an attack worse. Patients who are dehydrated or
take medicine to remove excess water (diuretics) due to hypertension
could be at greater risk. Some other medicines can also increase
risks. The chance of gout symptoms tends to be higher for people who
are obese or who have diabetes, anemia, blood cancer, kidney disease
or an underactive thyroid.
Gout can improve with a healthy diet. Certain eating habits can
make gout worse. They include drinking alcohol and eating high-fat
and purine-rich foods such as sardines, organ meats and brewers'
yeast. Brewers' yeast is often used in breads, gravies, casseroles,
dips, spreads and soups. Purines are a type of protein found in many
foods. Foods that increase acid levels in the body might also
At first, uric acid-lowering treatment might cause a joint to
become sorer as crystal deposits break up in a joint.
What you should do
Take recommended medicines to reduce inflammation in a joint as
soon as you have a gout attack. Ibuprofen (for example, Advil or
Motrin) or naproxen (such as Aleve) helps many people.
Get professional help when symptoms occur. Visit your primary
care provider to see if you need a rheumatologist.
Get serious about your lifestyle. Avoid things that can trigger
attacks. Drink plenty of water to flush uric acid from your body.
Avoid alcohol and animal proteins from meats and fatty and purine-
Reduce the chances of more attacks by losing weight slowly but
surely. Exercise regularly and eat small portions.
Be sure to include complex carbohydrates in your diet. A lack of
carbohydrates can lead to ketosis, which can eventually increase the
level of uric acid in your blood.
Get professional advice about medicine. Tell your care provider
about the medicines and vitamins you are taking. Some, such as
aspirin, niacin and diuretics, might be increasing your gout risks.
Some anti-inflammatory medicines might be harmful if you have kidney
disease or ulcers. Aspirin can also interfere with some uric-acid-
lowering medications. Don't just stop recommended medicines on your
Rest an inflamed joint. Use an ice pack to reduce pain and
For more information
Learn about gout at niams.nih.gov/Health_Info/ Gout/default.asp.
See acumedico.com/purine.htm for a list of purine-rich foods to
Better Health: Take Charge! is provided by the Healthy Memphis
Common Table: www.healthymemphis.org. This article supports the care
and advice of your doctor.