If your body makes too much uric acid or expels too little, uric acid blood levels can build up...
Q: I have had two attacks of gout in the past six months. What’s the best way to get quick relief and prevent it from happening?
A: Gout is the most common type of inflammatory arthritis. It’s caused by the crystallization of uric acid within the joints.
Your body naturally produces uric acid, which is a waste product of cells. Uric acid is dissolved in your blood and passes through your kidneys into your urine. However, if your body makes too much uric acid or expels too little, uric acid blood levels can build up. This can lead to urate crystals forming in a joint, tendon, and the surrounding tissue. The result: sudden, painful inflammation. While a gout attack can occur at any time, it is most likely to strike at night.
For Sudden Episodes of Gout Symptoms, Use the Following:
Medication. In some cases, an over-the-counter nonsteroidal anti-inflammatory drug like ibuprofen (Advil, Motrin IB) or naproxen (Aleve) is enough to control the symptoms. But many people need a prescription dose of an anti-inflammatory drug, corticosteroid pills (prednisone), or the drug colchicine. A corticosteroid can also be injected into your joint to help control pain.Ice.Wrap a cold pack in a thin towel and apply it to the joint for 20 to 30 minutes several times a day.
Rest. Rest the joint on a pillow and try not to move it until the pain subsides.
The best way to stop recurring and severe attacks is to lower blood uric acid levels to less than 6 milligrams per deciliter [mg/dL]. This is where urate-lowering therapy (ULT) comes into play. ULT should be considered for people who have two or more gout flare-ups per year and those who have joint damage caused by gout.
Here’s a Look at Each Component of the Approach:
Diet and lifestyle. Reduce your intake of meat and shellfish. Cut back on alcohol and foods or drinks made with high-fructose corn syrup, like soft drinks. Stay well hydrated. Manage your weight, as gout is linked with excess weight and obesity.Medication. Diet alone seldom lowers uric acid levels enough, so a prescription drug is usually needed. Most often doctors prescribe allopurinol. However, it’s important to stop allopurinol and call your doctor’s office if you develop a rash while on the drug, especially if you also have fever.
Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.
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