Treating gout attacks at home

Gout as a disease of kings was described many centuries before our era. More than 5 out of a thousand people worldwide suffer from gout (a disease of the musculoskeletal system). Men are the absolute majority of these patients. The most common age for men who suffer from gout is after 40 years, and for women - the period of the onset of menopause, after 45 years. With gout, the joints of the hands, feet, fingers, elbows hurt a lot. But the toes suffer from it the most. How to treat gout at home yourself and how to cope with its attacks?

What is Gout – Quick Facts

Gout is a type of joint disease that is rheumatic in nature. Pain occurs due to the deposition of urates, which are uric acid salts.

If you have gout, you know how miserable you can be during attacks. There's nothing you can do to stop a gout attack once it starts, but there are things you can do to take care of a gout flare-up at home.

An attack of gout occurs when the body's normal uric acid levels increase, causing a buildup of uric acid around the joint. The uric acid forms crystals there, causing painful gout flare-ups. Many things, including alcohol abuse, eating certain foods, stress, and taking medications without proper supervision, can cause the amount of uric acid to start to increase, leaving you open to gout.

Warning Symptoms of Gout

Some people with gout, also known as gouty arthritis, know that a gout attack begins with a burning, itching, or tingling sensation. These signs may begin an hour or two before a gout attack. Shortly after these warning signs, a person begins to feel the telltale signs of gout. If you have recurring gout attacks, you will already know from your body's signals that a gout attack is about to begin.

For example, a person may wake up in the middle of the night feeling severe pain in the joints of the legs.

When a gout attack begins, most people experience redness, swelling, and severe pain — usually in one joint. The most common site for gout is the big toe, but pain can also occur in other joints, such as the elbows, knees, wrists, ankles, and feet.

The pain is often so severe that it hurts to touch the sore spot at all. Many people who suffer from gout can confidently say that even the sensation of a sheet touching an inflamed joint is very painful.

Can't eliminate purines?

It is impossible to eliminate all purines from the body and reduce the risk of gout attacks. But there are a few foods that contain high amounts of purines that do not cause gout. One study found that peas, beans, mushrooms, cauliflower, spinach, and chicken, previously thought to be good for people with gout, were not associated with attacks.

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How to Find a Diet That Works for You

Being overweight increases your risk of gout. So, eating a balanced diet and losing excess weight can help reduce gout symptoms. Talk to your doctor about making dietary changes. You may find that you can now eat some foods without triggering a gout attack. Other foods may trigger your body to react and may make gout attacks more frequent.

Gout is caused by excess uric acid in the blood. Over time, uric acid crystal deposits collect around bone or cartilage. The uric acid buildup may not cause any gout symptoms – but that’s only at first glance. If an area of the body becomes inflamed, a gout attack will occur later, with swelling, redness, and pain.

Acute gout attacks can be treated with anti-inflammatory drugs such as ibuprofen or stronger prescription drugs. But after the first attack, there is about an 80% chance of another gout flare-up within the next two years.

Some medications are approved to lower uric acid levels and reduce the risk of flare-ups. But in patients with serious underlying conditions, gout can be difficult to treat effectively.

Here are some of the most common comorbidities that complicate treatment:

• High blood pressure.
• Diabetes.
• High cholesterol levels.

What becomes a chronic problem with gout?

When uric acid levels in the blood become too high, more uric acid crystals are deposited around the cartilage. Gout becomes a chronic condition, causing painful, damaging, and destructive joints.

Of course, the attacks and type of gout vary greatly depending on the characteristics of the person. Signs that health may be worsening with chronic gout include:

• More frequent and longer flare-ups of gouty arthritis: severe pain in the extremities. As chronic gout worsens, flare-ups of pain occur more frequently and last longer. Over time, inflammation causes damage to bones and cartilage.
• Pain flares in other parts of the body. In about half of all patients with gout, the first attack of pain occurs in the joint at the base of the big toe or thumb. In chronic gout, other joints may also be affected, including the ankle and knee.
• Lumps that form under the skin. Uric acid crystals can begin to collect in soft tissue, forming lumps called tophi. They commonly appear on the hands, fingers, elbows, and ears, but can appear almost anywhere on the body.
• Kidney problems: Uric acid normally passes through the kidneys. Kidney disease can cause uric acid crystals to build up and cause gout. But excess uric acid can also damage the kidneys. Kidney problems associated with chronic gout are also signs that chronic gout is getting worse. This includes attacks of kidney pain, kidney stones, and kidney failure.

Gout and development of tophi

Tophi, which are a sign of chronic gout, can appear anywhere on the body. But they are most likely to form on the cartilage of the ear or ear shell, elbows, Achilles tendon, and around affected joints. Other complications associated with chronic gout include kidney stones and kidney disease.

To diagnose gout, doctors typically measure uric acid levels in the blood. Uric acid levels of 6.8 mg/dL or higher can lead to the formation of uric acid crystals. However, uric acid levels are not a good indicator of the severity of gout.

Some people have significantly elevated uric acid levels - and no gout symptoms. Others may suffer from severe gout attacks and only have mildly elevated uric acid levels. If uric acid levels reach 11 mg/dL, doctors will usually recommend lowering uric acid levels with medication, even if there are no gout symptoms.

The goal of gout treatment is to bring the uric acid level in the blood to at least 6 mg/dL, or even lower if the patient has tophi. When the uric acid level drops low enough, the uric acid crystal clusters begin to dissolve. And that's a great result.

Home Care During a Gout Attack

If gout has been diagnosed and your doctor has given you medication to suppress gout attacks, you should take the medication as directed by your doctor during attacks.

Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Aleve), ibuprofen (Motrin, Advil), indomethacin (Indocin), sulindac (Clinoril), celecoxib (Celebrex), or meloxicam (Mobic) or suggest you take over-the-counter medications at a prescribed dose. These are usually effective.

In some cases, you may already be taking medication to help prevent a gout flare-up. Your doctor may suggest:

• allopurinol (Lopurin, Zyloprim)
• colchicine (Colcrys)
• probenecid (Benemid)
• anturane (sulfinpyrazone)

If you continue to have gout attacks, it does not mean that these medications are not working. In the first few months that you are taking treatment for this type of gout, you may continue to have attacks and still have your body respond to the medications. Continue taking your preventative medications as well.

If you have been taking gout preventatives for a long time and this is the first time you have an attack, talk to your doctor. He or she may recommend changing your dose or medication.

Increasing fluid intake during gout attacks

Changing your diet can help you manage chronic gout and help reduce symptoms such as joint pain. Practice increasing fluids first, as dehydration can trigger gout attacks. One study found that men who drank 5 to 8 glasses of water in a 24-hour period had a remarkable result: a 40% reduction in the risk of gout attacks. But you should also avoid sugary soft drinks, which can increase the risk of an attack.

Monitor your intake of foods containing purines

People with gout may benefit from eating foods low in purines. Purines are substances that occur naturally in many foods. The buildup of uric acid that causes gout occurs due to the breakdown of purines.

Certain foods, such as organ meats, sardines and anchovies, are high in harmful substances called purines. You should avoid them if they can trigger a gout attack.

But you can still eat foods with lower amounts of purines, such as beans, lentils, and asparagus. Talk to your dietitian about what foods you can safely include in your menu.

Eat lots of fruits

Fruits are generally very low in purines. But they provide complex carbohydrates and other nutrients that can help you stay healthy. Some fruits may help with gout attacks. There are fruits high in vitamin C, such as tangerines and oranges, that may help prevent gout attacks. Some studies suggest that eating cherries or drinking cherry juice may help people with gout. Ask your doctor if you can add cherries to your diet.

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Choose the right carbohydrates

If you follow a low-carb diet that is also high in protein or fat, you may end up consuming too many harmful purines. Foods high in protein tend to be high in purines. Refined carbohydrates, such as bread and pasta, contain very little purine. But you don’t want to gain weight from these carbohydrates. So instead, focus on healthy, high-fiber carbohydrates, such as oats, sweet potatoes, beans, and vegetables.

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Essential Fats for Preventing Gout

Increase your intake of fatty acid-rich foods, including deep-sea fish like tuna and salmon, flaxseed and other seeds, and, of course, nuts. Fatty acids can help reduce joint inflammation. Use fatty acids like olive oil for cooking and salad dressings. And try to reduce or eliminate any trans fats in your diet.

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Limit alcohol

Alcohol can increase your risk of gout because it is a drink with high levels of harmful purines, especially if you drink more than one drink a day. Beer appears to be even worse than other alcoholic drinks because it contains yeast. Moderate wine consumption does not increase your risk of gout.

Use caffeine with caution

Moderate coffee consumption is considered a good approach for people with gout. And some regular coffee drinkers drink four or more cups of coffee a day — which may reduce the risk of gout attacks. But caffeinated drinks can increase uric acid levels in some people who just drink coffee occasionally. Talk to your doctor about how often you should drink coffee and how caffeine consumption triggers a gout attack.

Enjoy low-fat dairy products

Dairy products were once taboo for people with gout because they are made from animal proteins. But dairy products are actually low in purines and milk purines, so they do not trigger gout attacks.

In fact, drinking skim milk and eating low-fat dairy products can reduce your risk of developing gout by more than 40%. During a gout attack, low-fat dairy products can help you get rid of excess uric acid through your urine.

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Control of chronic gout

After the initial attack, doctors usually wait until gout starts bothering a person again before recommending medications that lower uric acid levels. Because of possible side effects, doctors are reluctant to put patients on long-term therapy until they are sure that gout is truly chronic. However, doctors may recommend a medication that slows the development of tophi.

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New treatment options for gout

Several drugs have long been used to treat chronic gout by lowering blood uric acid levels, including allopurinol (Lopurin, Zyloprim) and probenecid (Benemid). Importantly, these drugs can be taken throughout life to keep blood uric acid levels at appropriate levels.

New promising treatments are being tested that could offer new hope for people with chronic gouty arthritis. Findings from basic research will lead to new gout treatment options in the future.

Harmful drugs

Ironically, uric acid-lowering drugs can sometimes cause a flare-up of gout, especially during the first two weeks of treatment. As the drugs begin to break down the uric acid crystals, you may experience a sudden inflammatory reaction. To prevent a flare-up of gout pain, doctors prescribe anti-inflammatory drugs as well as uric acid-lowering drugs. Most experts recommend continuing anti-inflammatory drugs for 6 months to ensure that the uric acid build-up is completely eliminated.

Treatment for gout can be complicated in patients with other serious medical conditions, such as kidney disease. However, experts say many patients should not suffer repeated attacks of gout or joint damage if treatment is effective.