You should seek medical care if you have sudden, severe pain in a joint; especially if you have a fever and the joint is swollen, hot, and red. Consult your doctor, even if the pain goes away after a day or two. If you have gout and do not treat it, you may develop permanent joint damage.
If you have a fever and the joint is inflamed, you should call your doctor right away, as these symptoms may signal an infection.
Certain lifestyle changes, especially in your diet, are helpful for preventing future attacks. Various lifestyle changes can contribute to keeping your uric acid level in the normal range, thereby reducing your chances of future attacks. These changes augment the medicines that your doctor may prescribe.
- Avoid eating large amounts of animal protein, which contains purines. Liver, kidneys, sweetbreads, brains, anchovies, shrimp, sardines, fish roe, yeast, herring, and mackerel are especially rich in purines. Vegetables that contain purines include mushrooms, asparagus, cauliflower, and spinach.
- Drink large amounts of fluids, especially water, to dilute the uric acid in your urine. At least 3 quarts a day is recommended. This may also reduce the risk of kidney stones.
- Avoid alcohol, which inhibits excretion of uric acid by the body and also lead to increased uric acid production. If you must drink alcohol, do not exceed two drinks a day if you are a man and one if you are a woman.
- Lose weight if you are overweight. This will decrease the load on your affected joints and may reduce your level of uric acid. You should lose weight slowly, since rapid weight loss may temporarily increase your level of uric acid.
Rest, drink large amounts of fluid, and immobilize affected joints to help relieve pain during an acute attack. It may be helpful to use a splint, or a device that holds the affected joint still, to decrease pain. Rest is also important as you recover from an acute attack. Drinking large amounts of fluid helps to prevent crystals from forming in your kidneys.
Your doctor is the best source of information on the drug treatment choices available to you.
Most tophi shrink on their own as your uric acid level decreases. However, very large tophi may be removed by surgery.
Most people with gout can control their symptoms and live normal lives if they receive the right treatment. If your gout is diagnosed early and you follow your treatment plan carefully, the disorder should not adversely affect your lifestyle. Even in cases of severe gout, treatment can remove tophi, increase joint function, and prevent kidney stones.
You should make follow-up appointments with your doctor to assess the success of treatment. Your doctor will check your uric acid level at regular intervals to determine how effective your drug therapy is. If your condition does not respond to the standard drug treatments, the doctor may recommend that you visit a rheumatologist, who is a physician who specializes in disorders of the joints and connective tissue.
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