Treating Gout

Gout symptoms occur when high levels of uric acid cause deposit of sodium urate crystals in the joints where they cause inflammation or gouty arthritis. After suffering a few days with intense gout pain, you typically have 6 to 12 months before you have to endure your next round of gout symptoms.

Gout symptoms cheat sheet

• unlike other forms of arthritis, gout attacks happen "suddenly" without prior stiffness
• the first gout attack happens mostly at night in your toe
• gout attacks can be accompanied by upset stomach or flu-like fever symptoms
• at first gout symptoms disappear completely after a few days
• without gout treatment the crystals will accumulate in the joint to form lumps – called tophi – which will remain swollen and painful between gout attacks
• hyperuricemia or long term high levels of uric acid ( > 6mg/dL ) in the blood. However it can be that at the moment of your gout attack, your uric acid level in your blood is normal
• to be sure: examine the presence of uric acid in the fluid of the affected joint

For people with a long history of gout attacks, lumps of urate salts – or tophi – may also occur on the edge of the outer ear and the back of the hand, elbow, heel or toes. Gout diagnosis involves again a simple sample to determine the presence or absence of gout crystals.

Chronic symptoms of gout tophi after not treating gout

Gout and pseudogout symptoms diagnosed

Since gout attacks mimic joint infections and a sample has been taken of your joint fluid, do ask your doctor to also examine the joint fluid for the presence of bacteria and pseudogout crystals that form when there is too much calcium in your blood.

Some pseudogout symptoms are similar to gout symptoms: a sudden and fast painful and hot swelling of a joint, although people with pseudogout are normally older than people with gout and the affected joint is bigger than with gout, most commonly pseudogout symptoms occur in one knee.

There are people with high levels of uric acid in their blood who will never show any gout symptoms, although it is still unknown why these people don’t develop gout crystals. Most likely these people have damaged kidneys and excrete more uric acid than normal. For most people however it is clear that a long term high concentration of uric acid in the blood will increase the chances of gout crystals deposits in the joint and cause gout.

Why do gout symptoms only appear suddenly

It is not clear why after many years of hyperuricemia in the blood suddenly a gout attack occurs. It is noted however that most gout symptoms show after so called "stress gout triggers" like:

• surgical operation
• injury
• excessive beer drinking
• eating purine rich food.

The good news however is that these gout crystals can dissolve in uric acid again and get excreted in the urine like they should have. On the downside, new gout crystals can be formed again as well causing another round of painful gout symptoms.

Early gout symptoms

It is noted by people who keep a gout diary that a gout attack occurs:

• after a fever
• after not feeling well
• after a stomach upset
• after noticing a very yellow urine: a sign of dehydration, hence not enough water to excrete the uric acid.

Gout symptoms and treatment

What causes gout is the accumulation of uric acid in the blood that gets deposited as crystals around the joints (the same crystals that cause kidney stones). Uric acid is a waste product in the blood. Cures for gout aim to reduce
the amount of gout uric acid:

• by drugs:
• allopurinol to lower the  uric acid production in your body
• probenecid to help your kidneys to remove more uric acid from your body
• by avoiding foods rich in purines.

Pain gout symptoms treatment involves pain relief through:

• NSAIDs : non steroidal anti inflammatory drugs taken orally
• glucocorticosteroids taken orally or injected in the painful joint
• colchicine taken orally within the first 12 hours of the gout attack
• intramuscular or subcutaneous injection of adrenocorticotropic hormone.

Gout symptoms and women

Gout is a metabolic disease most often affecting middle-aged to elderly men and postmenopausal women. Gout used to be called the disease of kings and not the disease of queens. However more women with high blood pressure who are taking diuretic medicine – water tablets – increasingly show gout symptoms compared to the times there weren’t any duiretics.

Gout symptoms and gout diet

There is a clear relation between food and gout. During the first and second world war in Europe, gout symptoms were as scarce as food was. A modern diet for gout sufferers doesn’t have to be as drastic as during these wars. However symptoms of gout disappear when people have no chance to become obese and the opposite logic: the more rich your diet becomes, the more you will have chances to develop gout.

Gout is the only form of arthritis where the symptoms can be controlled with a gout therapy that avoids foods that cause gout. In other words you follow the so called gout diet. Simply cutting down slowly but surely on calories and reduce obesity also helps in gout prevention.

Living with gout should be enjoyable in the 21st century when you keep a gout diary to discover your personal diet for gout. Write down everything you eat, as some people show gout symptoms after eating lemon juice, oranges, strawberries and even tomatoes. Other people find that drinking cherry juice is an effective gout remedy. Main thing is that each person has to find out for himself what foods cause gout and what gout diet foods are beneficial in their cure for gout.

Everybody has a different metabolism, yet experience shows that changing your eating habits, especially following a gout purine diet – reducing your intake on purine rich foods – does help control gout symptoms. Research is in progress to pinpoint food good for gout: some foods like low-fat dairy products seem to lower the risk developing gout attacks.

Gout symptoms summarized

Gout symptoms appear suddenly in one joint, are extremely painful and go away in 3 to 10 days. The symptoms are always triggered or after a stressful event, eating the wrong food or getting dehydrated. However gout symptoms only occur in people with a long term high level of uric acid in their blood.

Gout symptoms may re-occur every 6 to 12 months but shouldn’t re-occur with adequate gout management based on gout prevention medicine, reducing intake of diuretics and especially a change in diet and lifestyle. The best gout self help for gout sufferers is keeping a gout facts diary where they write down what they eat, what they drink, what they do for exercise and what happened before gout attacks.

Acute gout pain relief is similar to reducing the pain in any other arthritis diseases by using NSAIDs or corticosteroids.