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Acute gouty arthritis

What is it?

Gout is a disease that causes your joints to hurt. The pain is caused by uric acid crystals in a joint. Uric acid comes from the natural breakdown of chemicals called purines (pure-eens). Purines are normally found in some foods and medicines and in body cells. Gout is more common in men over 40 years of age. A gout "attack" may last a few days and can be treated with medicine. Gout attacks can return again and again. Some people with gout are more likely to have problems with kidney stones.

Causes:

Gout may be caused because your body makes too much uric acid. Or, it may be caused if enough uric acid does not leave your body when you urinate. Different things can cause a gout attack, such as some food or medicine, like cancer treatment. An injury, illness, dehydration, or surgery may also start a gout attack.

Signs and Symptoms:

You may feel sudden severe pain in a joint, usually at the base of the big toe. It can affect the shoulder, elbow, knee, hand, foot, ankle, or arm joints. The joint may be red, hot, swollen, and very tender. You may have a fever and the skin over the joint may look shiny and red.

Wellness Recommendations:

Drink 8 to 10 glasses of water (soda-pop can size), cranberry juice, or other liquids daily. This helps your body get rid of uric acid. Do not drink liquids that contain alcohol as alcohol slows the passing of uric acid from your body.

Medical Care:

Caregivers may want you to rest in bed for 24 hours after an acute attack to lessen pain. Raising the sore joint on pillows may also help. After 24 hours, too much bed rest may make your gout worse. Follow caregiver's instructions carefully.

You may need to take medicine to lessen the redness, swelling, and joint pain (inflammation (in-fluh-ma-shun)) during an acute attack. You may be given a steroid shot to decrease inflammation. It may be given into the swollen joint affected by gout.

Use ice on your joint to lessen pain and swelling. Use it on the sore joint for 15 to 20 minutes out of every hour as long as you need it. You may also try warm moist compresses followed by cold compresses. A warm moist compress is a small towel dampened with hot water and placed in a plastic bag. Wrap a towel around the plastic bag to prevent burns. Put the warm compress on for 3 minutes. Then put the cold one on for 30 seconds. Repeat this every hour as long as you need it.

Dietary Measures:

  • Do not eat sweetbreads, sardines, shellfish, anchovies, or organ meats (kidney or liver). These foods have a lot of purines in them. Other foods to avoid are herring, mackerel, turkey, mushrooms, spinach, asparagus, legumes (dried beans, peas, soybeans), and cauliflower. It may be helpful to eat less meat and more tofu.
  • Do not drink alcohol, especially beer.
  • Foods that may be helpful are cherries and dark berries (blueberries, blackberries, boysenberries). These fruits contain chemicals that lessen uric acid in the body.
  • If you take vitamins, too much vitamin A may increase gout attacks.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Herbs:

    Supplements:

      Complementary Therapies:

      • Acupuncture has proven helpful for some patients with gout.

      Other ways of treating your symptoms : Other ways to treat your symptoms are available to you.

      Talk to your caregiver if:

      • You would like medicine to treat gout.
      • Your symptoms have not gone away or improved by these self-help measures.
      • You have questions about what you have read in this document.

      Care Agreement:

      You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

      References:

      1. Emmerson BT: The management of gout. N Engl J Med 1996; 334(7):445-451.

      2. Ralston SH, Capell HA, and Sturrock RD: Alcohol and response to treatment of gout. BMJ 1988; 296:1641-1642.

      3. Zherebkin VV: The use of acupuncture reflexotherapy in the combined treatment of patients with chronic gouty polyarthritis. Lik Sprava 1998; (2):151-153.


      Last Updated: 12/4/2015

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