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Gout Attacks

Gout attacks, also called gouty arthritis attacks, are unpredictable, and that makes coping with them difficult. People are quite shocked when one day, joint pain hits for the first time—and lots of it. But even those who experience more attacks will be surprised each time, because there’s no sure way to know when the next one will hit.

Often (but certainly not always) people have a good idea of what triggers their attacks. A trigger causes a sudden increase in the blood levels of uric acid or causes the deposits of crystals inside the joints to shift, which sets off a storm of intense, painful inflammation.

Gout Attack Triggers

Here are some of the most common gout attack triggers:

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  1. Eating certain foods (like shellfish, organ meat and red meat) results in more purine for the body to break down into uric acid. This surge in uric acid levels can trigger a gout attack.
  2. Drinking too much alcohol, especially beer, in a short amount of time increases the body’s production of uric acid.
  3. Consuming too much high-fructose foods and drinks, like sugary soft drinks, juices and anything with high-fructose corn syrup as an ingredient, are common triggers.
  4. Dehydration (sometimes caused by fasting) lowers the total volume of blood, which increases the concentration of uric acid.
  5. “Fasting and feasting,” including extreme low-calorie or unbalanced diets and large portions of certain foods or sugary sodas are known to be triggers.
  6. Certain medications, like diuretics (“water pills”), used to treat high blood pressure, leg swelling (edema) or heart failure, increase urine output and decrease the kidneys’ ability to filter uric acid, which raises the blood uric acid levels.

What to Do: Tips and Treatments

Know how to treat an attack! The key to treating an attack is reducing inflammation quickly, which will relieve pain and end the attack sooner.

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Take anti-inflammatory medication soon after the pain starts.

Anti-inflammatory medication can shorten the duration of the attack, especially if it’s taken as soon as possible within the first 24 hours.

If you’ve been diagnosed with gout, your doctor may have given you an anti-inflammatory medication (with dosing instructions) to keep on hand, just in case. Some anti-inflammatories are available without a prescription and others are prescribed, including:

  • Anti-inflammatories, such as an NSAID (pronounced en-said, short for nonsteroidal anti-inflammatory drug)
  • A corticosteroid that can be taken by mouth or injected,
  • Colchicine, a drug that’s been used, in some form, for about 2,000 years to relieve the inflammation of attacks.

If you are in pain and may be having your first attack, call your doctor right away to ask about anti-inflammatory medication.

Use ice.

Applying ice and elevating the joint can help ease the inflammation in addition to your medication. If the pain is still extreme, your doctor may prescribe or recommend pain medication to help.

Ask for help.

Let the friends and family members on your team know you’re having an attack. They can run your errands, pick up prescriptions and even fill your ice packs while you’re sidelined.

Will the Pain Ever End?

When you are in the middle of a gout attack, you might think the pain will never end. It may help to know that even without treatment, the first 36 hours are the worst, with gradual easing of the pain over the next week to 10 days. Getting anti-inflammatory treatment quickly may shorten the length of the attack by about half.