An
acute gout attack is an inflammatory process that occurs in a joint
secondary to a high concentration of uric acid in the blood. It is most
commonly seen in the middle age, elderly and is much more common in men. It
can occur in any joint in the body but is most commonly seen in the big toe
joint followed by the knee and the ankle. It is extremely painful and is
characterized by a red, hot, swollen joint. Patients who are undergoing
acute gout attacks are usually in extreme pain and find it most difficult to
even bear weight during normal walking. Sometimes just the touch of the bed
sheets over the area can illicit a great deal of pain.
What causes
it?
An acute
gout attack results when elevated levels of uric acid in the blood cause
crystals to settle into certain joints. The body's defense mechanism tries
to fight the foreign material and an inflammatory process is initiated. Uric
acid is a metabolic end product that is normally found in certain foods.
People that experience "gouty attacks" have increased levels of uric acid
for a variety of reasons. Often very rich foods like alcohol, chocolate,
seafood, and meats can precipitate attacks. Sometimes the medication we
take can cause the body to increase the uric acid levels. The uric acid
crystals settle in joints in one's arms and legs because of the decreased
temperature seen in the extremities. The crystals are recognized as foreign
material and the body fights it like an infection. The area becomes swollen,
red, hot and extremely painful. This is one of the most painful conditions
we treat.
How do you
treat it?
Acute gout
attacks are usually treated with a combination of therapies. Oral
medications such as anti-inflammatories, analgesics and colchicine are most
commonly used to treat this disorder. Often times, local injections into the
affected joint will help relieve symptoms. Various other treatments include
warm compresses, elevation of the involved area, physical therapy, and the
use of pain relievers such as narcotics. The goal of treatment in acute gout
attacks is to end the "flare up" and convert the patient's condition to the
chronic state. Going on a low purine diet can help prevent reoccurring
attacks.
Certain
oral medications are available on a long-term basis to help prevent
recurrent attacks and possible systemic damage. One should consult his or
her family physician or internist for information on these medications. |