Certain medications can increase your uric acid levels and your risk of developing gout. These include:. Uric acid is created when the body breaks down purines. Eating foods that contain a high level of purines can increase your risk of gout. Beer, fortified wines like port, and spirits do this more than wine.
Moderate consumption of wine — one or two glasses a day — shouldn't significantly increase your risk of gout. Some research has found that drinking sugar-sweetened soft drinks and drinks with high levels of fructose a naturally occurring sugar found in many fruits had an increased risk of gout. Studies have shown that gout often runs in families.
Around one in five people with gout have a close family member with the condition. Your GP may suspect gout based on your symptoms. Sometimes further tests will be needed to confirm the diagnosis and rule out other possible causes. See your GP if you experience symptoms of gout for the first time.
Your GP will ask about your symptoms and medical history, and examine the affected area, to help make a diagnosis. They may also ask you about your diet, particularly your intake of beer, spirits and foods high in purines, such as red meat and seafood. Your GP may be unable to make a firm diagnosis straight away and you may be referred for further tests. These will either confirm the diagnosis of gout or rule out other conditions.
A sample of fluid may be taken from the affected joint. The fluid can be checked for the small crystals that cause gout, and it can be tested for infection to rule out septic arthritis. A blood test known as a serum uric acid test may be used to measure the amount of uric acid in your blood. A high level or uric acid is often associated with gout.
This is because the level of uric acid in your blood can drop when uric acid crystals form in the joints. An X-ray is rarely used to diagnose gout because the condition isn't usually detectable using this method. However, an X-ray is sometimes used to help rule out similar conditions that affect the joints, such as chondrocalcinosis a build-up of calcium crystals in the joints or to assess whether there has been any joint damage due to repeated or persistent attacks of gout.
An ultrasound scan of an affected joint is a simple and safe investigation that's increasingly used to detect crystals in the joints. It can also detect crystals deep in the skin that aren't obvious during a physical examination. Treatment for gout includes pain relief to help you cope with a gout attack, as well as medication and lifestyle changes to prevent further attacks.
Apply the ice pack to your joint for around 20 minutes. Don't apply ice directly to your skin and don't apply it for more than 20 minutes at a time because this could damage the skin. If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first. Non-steroidal anti-inflammatory drugs NSAIDs are usually recommended as the first treatment for gout.
They work by reducing pain and inflammation during an attack. If you've been prescribed NSAIDs, it's a good idea to have them with you at all times so you can use them at the first sign of a gout attack. Continue to take your medication throughout the attack and for 48 hours afterwards. This reduces the risk of the NSAID causing indigestion , stomach ulcers and bleeding from the stomach. It's best to have it with you at all times so you can use it at the first sign of a gout attack.
Your GP will tell you how long to take it for and how often. When taken in high doses, side effects of colchicine include feeling sick, abdominal tummy pain and diarrhoea. Corticosteroids are sometimes used to treat severe cases of gout if other treatments don't work or you're unable to take an NSAID or colchicine.
A short course of steroid tablets often provides relief, but they can't be used long-term in high doses as they cause side effects, including:. Corticosteroids can also be given by injection to provide rapid pain relief. This can be either into a muscle, a vein or directly into the affected joint.
You can reduce your chances of having further gout attacks by taking medication and making lifestyle changes to reduce the level of uric acid in your body. Medication to reduce uric acid levels — known as urate-lowering therapy ULT — is usually recommended if you have recurrent attacks of gout or you have complications of gout.
Most people with gout will eventually need to have ULT, so you may want to discuss the advantages and disadvantages of this treatment with your doctor as soon as you've been diagnosed with gout. They should explain that while ULT can significantly reduce your risk of having further attacks, the medication needs to be taken on a daily basis for the rest of your life and there's a small risk of side effects.
If you decide to start ULT, a medicine called allopurinol is usually tried first. If this isn't suitable or doesn't work, other medications may be used instead. These medications are described below. Allopurinol helps reduce the production of uric acid. Are you tired of waiting two to three days to snag an appointment with the doctor?
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As a result, a doctor may advise a person with high uric acid levels to address factors possibly contributing to its buildup. This stage occurs when urate crystals in a joint suddenly cause acute inflammation and intense pain.
Stressful live events and excessive alcohol consumption could be contributors to flare-ups. This stage is the period in between attacks of acute gout. Between these periods, urate crystals may continue to build up in tissue. Chronic tophaceous gout is the most debilitating type of gout and may result in permanent damage to the joints and the kidneys. At this stage, people can have chronic arthritis and develop tophi in cooler areas of the body, such as the joints of the fingers.
Chronic tophaceous gout typically occurs after many years of acute gout attacks. However, it is unlikely that individuals who receive proper treatment progress to this stage. One condition that experts easily confuse with gout is calcium pyrophosphate deposition, known as pseudogout. The symptoms of pseudogout are very similar to those of gout, although the flare-ups are usually less severe.
The major difference between gout and pseudogout is that the joints are irritated by calcium pyrophosphate crystals rather than urate crystals. Pseudogout requires different treatments than gout. The body produces uric acid during the breakdown of purines. These are chemical compounds found in high amounts in certain foods such as meat, poultry, and seafood. Typically, uric acid is dissolved in the blood and excreted from the body in urine via the kidneys.
If a person produces too much uric acid or does not excrete enough, it can build up and form needle-like crystals. These trigger inflammation and pain in the joints and surrounding tissue. The main symptom of gout is intense joint pain that subsides to discomfort, inflammation, and redness. Read our guide to care and support if you:. Page last reviewed: 09 October Next review due: 09 October Non-urgent advice: See a GP if you have:. Ask for an urgent GP appointment or call if: the pain is getting worse you also have a very high temperature you feel hot and shivery you also feel sick or cannot eat These symptoms could mean you have an infection inside your joint and need urgent medical help.
Do take any medicine you've been prescribed as soon as possible — it should start to work within 2 days rest and raise the limb keep the joint cool — apply an ice pack, or a bag of frozen peas wrapped in a towel, for up to 20 minutes at a time drink lots of water unless a GP tells you not to try to keep bedclothes off the affected joint at night.
Important It's important to take uric acid-lowering medicine regularly, even when you no longer have symptoms.
Do get to a healthy weight, but avoid crash diets — try the NHS weight loss plan eat a healthy, balanced diet — your doctor may give you a list of foods to include or limit have some alcohol-free days each week drink plenty of fluids to avoid getting dehydrated exercise regularly — but avoid intense exercise or putting lots of pressure on joints stop smoking ask a GP about vitamin C supplements.
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