Acute gout attack: Danger alert

Gout is a disease caused by a disorder of uric acid metabolism, leading to the deposition of monosodium crystals in the tissues and is characterized by acute attacks of arthritis, common in middle-aged men and women after Menopause. The number of occurrences of gout is similar to the increase in uric acid levels in the blood.

Gout disease has 3 types:
Primary Gout Secondary Gout Congenital Gout Primary Gout is the most common case, and it is not clear what is the main cause to definitely cause the disease. Secondary gout is caused by hyperuricemia. Congenital gout is an inherited disease caused by a genetic abnormality.

Gout occurs in people with high blood uric acid (5-20%). Uric acid in the blood is high because the blood produces too much, or the kidneys reduce uric acid excretion.
Causes of increased uric acid production in the blood include: Genetic abnormalities. Increased catabolism of endogenous nuclear acids. Rapid degradation of ATP to uric acid. Excessive consumption of foods high in purines.
Causes of decreased uric acid excretion through the kidneys include kidney failure or patients using some diuretics, aspirin increasing drugs,...
Some risk factors for the disease: Middle-aged men or post-menopausal women, drinking a lot of alcohol, obesity, metabolic disorders, prolonged hyperuricemia, family history of gout, long-term use of drugs that increase blood uric acid.

Acute gout includes acute gout attacks, often occurring after a meal with too much meat (especially the type with a lot of purines such as dog meat, organs), after drinking a lot of alcohol. Strong emotions, heavy labor such as carrying heavy objects for a long time, traveling a lot, injuries (even minor injuries), infections... are also factors that cause pain to appear.
Acute gout attacks come on suddenly at night, causing joint pain, mostly the big toe joint. The joints are clearly swollen, hot, red, and painful to the touch, edematous, swollen, even a light touch is very painful, limiting movement and movement. During the pain, the person may have a high fever, chills, chills or moderate or low-grade fever, fatigue, loss of appetite or poor appetite, and little and red urine. In addition to the typical form, it can also be fulminant, presenting as intensely inflamed, painful joints and mild, subtle pain that is less easily missed.
The pain lasts usually 5-7 days, after which the signs of inflammation subside. Acute gout attacks are often recurrent, usually 1-2 times a year, then the interval between attacks is shortened, but it can also take more than 10 years to recur.

Follow a scientific lifestyle including moderate activities. During the acute arthritis period, you must let the joints rest and limit movement. During acute inflammation, patients should exercise regularly, avoid anxiety, and maintain BMI within normal limits. Limit foods high in purines such as viscera, red meat, and seafood in your daily diet. In particular, avoid alcohol, and eat a lot of green vegetables, foods and vegetables that contain a lot of fiber such as green bananas, beans, replace red meat with white meat such as pork, chicken and drink a lot of mineral water. .
Avoid taking some drugs such as diuretics, low-dose aspirin, long-term corticosteroids so as not to increase blood uric acid. In addition to changing daily habits, patients need to treat concomitant diseases such as hypertension, dyslipidemia, diabetes,...

To treat gout, diet is very important, so it is necessary to pay attention to meals as in every meal, you should not eat too much meat with a lot of purines and limit alcohol. The principle of early, fast, and strong treatment must be followed in acute gout attacks.
Use of non-steroidal anti-inflammatory drugs (NSAIDs) in patients without other medical conditions, this type should be chosen because the drug has a rapid effect starting with a high dose in the first 2-3 days and gradually reducing the dose in the first 2 to 3 days. 2 weeks.
Colchicine is the second choice in the treatment of acute gout because of its narrow therapeutic window and toxicity. The drug interferes with the phagocytosis of leukocytes with urate crystals. Take 2-3 times a day 1 tablet 1 mg each time, up to 4 tablets, and the dose is gradually reduced to 1 tablet x 2 times in the second day and 1 tablet / day for the next 3 days. Maintenance dose to avoid pain recurrence is 1 tablet per day, taken for 3 months or longer. If there are other diseases such as liver failure, kidney failure, bone marrow failure, when using it, it needs to be closely monitored by a doctor.
Corticosteroids are drugs used in patients who cannot take non-steroidal anti-inflammatory drugs or colchicine due to intolerance or contraindications due to other comorbidities. intravenously, intramuscularly, or intra-articularly.
Vinmec International General Hospital with a system of modern facilities, medical equipment and a team of experts and doctors with many years of experience in medical examination and treatment, patients can rest assured to visit. Gout examination and treatment at the Hospital.