Gout is a type of arthritis that is due to the buildup of uric acid in the blood. This results in the accumulation of sharp crystals that surround the joints, particularly the big toe joint. Gout commonly occurs in men more than women. The popular age to be affected with gout in males is 30 to 50 years. Women usually are affected with gout after menopause.
Significance
An acute gout attack occurs suddenly, usually at nights attacking the joint of the big toe. The pain is severe and excruciating; the joint is red, warm, tender, swollen and stiff. The pain is exaggerated by the slightest touch; even contact with the bed covers is unbearable. The goals in treating an acute gout attack is to quickly stop the excruciating pain and discomfort, reduce inflammation, prevent future attacks and avoid disability to the joint.
Approach to Treatment
As soon as an acute gout attack starts, contact your doctor for immediate medical attention treatment and advice. The sooner treatment is started, the faster the pain will be relieved. The four approaches to treatment are non-steroidal anti-inflammatory drugs (NSAIDS) like Indocin, Motrin and Naprosyn; aspirin; colchicines and corticosteroids (both anti-inflammatory); and analgesics for pain relief.
Choice of Drugs and Their Effects
NSAIDS are the first drug of choice in treating an acute gout attack. The maximum dosage of the chosen NSAIDS is given immediately and up until 24 hours after the attack is resolved. This is followed with a two- to three-days tapering off the dosage of the drug.
Colchicines is an effective anti-inflammatory for treating the an acute attack of gout. the maximum dose is given and then tapered off. When used at the maximum dosage it can bring on the side effects of vomiting and diarrhea.
Corticosteroids and Analgesics
Corticosteroids is the drug used for patients who are unable to take NSAIDS or colchicines. It is given as prednisone 20 to 40 mgs for three to four days. Then the dosage is tapered off gradually over a one- to two-week period. Analgesics are given to relieve the excruciating pain of an acute gout attack.
Additional Approach to Treatment/Prevention
This includes application of ice packs to the joint and elevation of the joint to further reduce the inflammation and swelling.
Adequate fluid intake is important to help in flushing the uric acid from the system. Maintaining control of your weight is important, since obesity predisposes one to having gout.
Decrease the use of alcoholic beverages and limit foods high in purines. Purines cause the build up of uric acid in the blood.
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