I have recently had an attack of gout, How can I prevent another attack
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547368 tn?1440541785
Hello Frank,

Welcome to the Pain Mangement Forum of MedHelp. I am very glad that you found us but so sorry to hear about your gout. It's hard to understand how painful a swollen toe from gout van be. My husband has struggled with it for years.

JayBay did a good job of copying the information with her copy and paste option. It's pretty comprehensive.

This use to be known as the King's Disease or the Rich Man's Disease. It is caused by depoists of uric acids into your joints. These crystals are from foods high in purines. Gravies, Scallops, Shrimp, Liver, Anchovies, Sardines, Great northern beans, Blackeye peas, Lentils, Beer, Soups, and much more. Apples and Turkey are huge factors for my husband. They will send him into an attack quickly. So know what triggers yours. Keeping a food diary can be helpful.

We tired all of the above approaches. He has none of the contributing conditions. My husband was dead set against taking medication. We worked closely with a dietitian and followed a very restricted and limiting diet as briefly outlined above.

Rarely did he cheat but he is human. After years of following the diet and still experiencing sudden and very painful attacks that seem to come from no where my husband chose to take one of the medications available to control the condition. He is on the very lowest dose of the medication. It. before the medication when he had been "good" for weeks and the attack still occurred this was very frustrated. It didn't seem to matter what he ate or drank after a while. Hence the decision to finally take the medication.

Now his attacks of gout are very infrequent and much, much less severe. He still avoids many of the food that can trigger an attack. If they occur he increases his medication for a day or two. He has always loved turkey and apples, which though healthy can often cause of an attack of gout. Now he can enjoy limited amounts of either.

I don't know what you are doing to control your gouty attacks. If you have not tried the diet it may be worth a trial period. If you have tried the diet and it is unsuccessful you may want to consider one of the medications. We are sorry that my husband did not go this route after the obvious failure of the restrictive diet. As I said even with the medication it does not give the ability to eat or drink whatever you want but it does allow for better choices.

Please et us know how you are doing. I wish you the very best. If you have additional questions please feel free to ask them.

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82861 tn?1333453911
Here is some info I found at Google Health.  It appears that you need to see a doctor if you haven't already.  Pay particular attention to the dietary and lifestyle changes section for managing gout.  Best of luck to you.  I know it's a terribly painful condition.

Gout is a kind of arthritis that occurs when uric acid builds up in the joints.

Acute gout is a painful condition that typically affects one joint.
Chronic gout is repeated episodes of pain and inflammation, which may involve more than one joint.

Symptoms of acute gouty attacks:

Symptoms develop suddenly and usually involve only one or a few joints. The big toe, knee, or ankle joints are most often affected.
The pain frequently starts during the night and is often described as throbbing, crushing, or excruciating.
The joint appears warm and red. It is usually very tender (it hurts to lay a sheet or blanket over it).
There may be a fever.
The attack may go away in several days, but may return from time to time. Additional attacks usually last longer.
After a first gouty attack, people will have no symptoms. Some people will go months or even years between gouty attacks.

Some people may develop chronic gouty arthritis, but others may have no further attacks. Those with chronic arthritis develop joint deformities and loss of motion in the joints. They will have joint pain and other symptoms most of the time.

Tophi are lumps below the skin around joints or in other places. They may drain chalky material. Tophi usually develop only after a patient has had the disease for many years.

After one gouty attack, more than half of people will have another attack.

Treatments for a sudden attack or flare-up of gout:

Your doctor will recommend that you take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or indomethacin as soon as your symptoms begin. You will need to take prescription-strength medicines for 4 - 10 days.
Your health care provider may occasionally prescribe strong painkillers such as codeine, hydrocodone, and oxycodone.
A prescription medicine called colchicine helps reduce pain, swelling, and inflammation.
Corticosteroids can also be very effective. Your doctor may inject the inflamed joint with steroids to relieve the pain.
The pain often goes away within 12 hours of starting treatment, and is completely relieved in 48 hours.
Daily use of allopurinol or probenecid decrease uric acid levels in your blood. Your doctor may prescribe these medicines if:

You have several attacks during the same year
You have signs of gouty arthritis
You have uric acid kidney stones
Some diet and lifestyle changes may help prevent gouty attacks:

Avoid alcohol, anchovies, sardines, oils, herring, organ meat (liver, kidney, and sweetbreads), legumes (dried beans and peas), gravies, mushrooms, spinach, asparagus, cauliflower, consommé, and baking or brewer's yeast.
Limit how much meat you eat at each meal.
Avoid fatty foods such as salad dressings, ice cream, and fried foods.
Eat enough carbohydrates.
If you are losing weight, lose it slowly. Quick weight loss may cause uric acid kidney stones to form.
See also: Kidney stones

Gout is caused by having higher-than-normal levels of uric acid in your body. Your body may make too much uric acid, or have a hard time getting rid of uric acid. If too much uric acid builds up in the fluid around the joints (synovial fluid), uric acid crystals form. These crystals cause the joint to swell up and become inflamed.

Not everyone with high uric acid levels in the blood has gout.

The exact cause is unknown. Gout may run in families. It is more common in males, postmenopausal women, and people who drink alcohol. People who take certain medicines, such as hydrochlorothiazide and other water pills, may have higher levels of uric acid in the blood.

The condition may also develop in people with:

Kidney disease
Sickle cell anemia and other hemolytic anemias
Leukemia and similar types of disorders
The condition may occur after taking medicines that interfere with the removal of uric acid from the body.

Tests & diagnosis
Tests that may be done include:

Synovial fluid analysis (shows uric acid crystals)
Uric acid - blood
Joint x-rays (may be normal)
Synovial biopsy
Uric acid - urine

Proper treatment of acute attacks allows people to live a normal life. However, the acute form of the disease may progress to chronic gout.

The disorder itself may not be preventable, but you may be able to avoid things that trigger your symptoms. Limit alcohol consumption and follow a low-purine diet.

Chronic gouty arthritis
Kidney stones
Deposits in the kidneys, leading to chronic kidney failure

When to contact a doctor
Call for an appointment with your health care provider if you have symptoms of acute gouty arthritis.
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