With the improvement of living standards, the incidence of gout is also increasing year by year, and the trend is younger. Previously, gout was mostly seen in older men after the age of 50, but now, it has started to spread to young men in their 20s. Like diabetes, gout is one of the hidden killers that are increasingly harming our health as we get richer. The acute phase of gout generally manifests itself as four major symptoms of redness, swelling and heat in the joints, often after drinking alcohol or a high purine diet, and waking up in the early hours of the next morning with a sharp pain in the big toe while sleeping. Many patients will think it is a sprain and go to orthopedics to see it, and take a film and find no problem. The first few attacks of gout are usually able to improve on their own within 1 week, but as the history of the disease gets longer, the attacks will become more frequent, and generally after 5-10 years, gout stones are formed and gout enters the chronic phase. Once it enters the chronic stage, the interval between gout attacks will become shorter and shorter, even to the extent that there is no interval between long-term attacks, the original eating a few colchicine or painkillers will be good, but at this time also has no effect. Patients generally have several common questions about gout: Why do I have gout even though my uric acid level is not high? There are many reasons why some of the patients with gout do not have high uric acid in their blood when they are checked. However, a common reason is that patients often have their blood drawn for uric acid when they run to the hospital for a gout attack. During an acute attack, uric acid excretion is facilitated by the precipitation of urate crystals in the joints and by the intense inflammation and pain that puts the body into a stressful state, producing adrenaline. These factors cause the concentration of uric acid in the blood to have dropped during the acute attack, so it is likely that uric acid is found to be in the normal range. Therefore, in order to determine whether uric acid is high or not, it is best to wait for about 2 weeks after the acute attack and then recheck the uric acid, so you will know what the usual baseline uric acid level is. How do I take colchicine? The instructions for colchicine have remained unchanged for decades, and it is written on the instructions that one capsule should be taken every 2 hours until the diarrhea or symptoms are relieved. In fact, this is a very dangerous way to eat. Colchicine is a drug with a large number of adverse reactions, and there are cross-actions with many other common drugs that can lead to increased toxicity, so we generally use it in small doses for a short period of time, rather than in large doses as written in the instructions. In addition to causing diarrhea and vomiting, high doses can also damage liver function and bone marrow hematopoietic function, and in severe cases can lead to granulocyte deficiency and drug-induced hepatitis. Then, the correct use of colchicine is as follows: during acute attacks, take one tablet (1mg) orally immediately, and then half a tablet (0.5mg) orally 1-2 hours later; after 12 hours, if it is still painful, take half a tablet (0.5mg) orally again; after that, take half a tablet twice a day until the joint improves, usually no more than one week. During the non-acute attack period, if the uric acid is high, the doctor will give uric acid-lowering treatment. During the first six months of uric acid-lowering treatment, gout is more likely to flare up, and at this time, you need to take half a tablet of colchicine (0.5mg) orally every day to reduce the recurrence rate; if there is really no recurrence after two or three months, you can also stop using it earlier. Colchicine has side effects, but as long as it is used correctly under the guidance of a rheumatologist, and blood tests and liver and kidney functions are regularly reviewed, it is still a good medicine for gout, although it can be used with confidence; What not to eat? The diet of gout patients has always been a big problem. I often tell my patients: nowadays, so many diseases come from eating, and starving makes them better. This is a joke, but in fact it is true. In principle, gout patients are mainly vegetarian, milk and eggs can be eaten, soybean products eat some appropriate also does not matter. However, life in the world, eating and wearing two things, if strict control of diet, many patients will find life uninteresting. Well, first of all, alcohol is a substance that definitely affects uric acid excretion, so gout patients must quit drinking, this is not negotiable. As for the diet, if the uric acid can be stabilized in the normal range for a long time after standardized uric acid reduction treatment, and the gout attacks are not many and not heavy, it is okay to eat some fish and shrimp meat appropriately, but don’t drink fish soup broth. Some patients may worry: will this food be malnourished? Do I need to take supplements? In fact, gout is over-nutrition, and further supplementation will only aggravate the disease. After six months and a year of a light diet, many patients not only no longer have gout attacks or very few attacks, but also have a better spirit and a better blood count, and the nutrients in their bodies are more balanced and reasonable. How to treat it? It is difficult to answer this question because each person has a different constitution and different disease, so the treatment plan is different. To put it simply, there are three types of drugs used to control redness, swelling and pain during acute attacks: colchicine; anti-inflammatory and analgesic drugs; and hormones. Depending on each person’s condition, one or two types of drugs can be used to control the disease; during the interval, the decision of whether to lower uric acid treatment is made according to the need, and the drugs are as follows: sodium bicarbonate tablets; benzbromarone tablets; allopurinol tablets, febuxostat tablets. Sometimes small doses of hormones, colchicine or anti-inflammatory and analgesic drugs are also combined. All of these need to be used under the guidance of a professional rheumatologist, so you should never be your own doctor. Can it be hereditary? The answer is not necessarily. There are certain genetic defects in the cause of gout, and many of those who have gout attacks at a young age often suggest that the genetic defects are more pronounced, and there is also a certain degree of family heritability. In some cases, the gout attacks occur in the 80’s and the kidney function is not good, but it is not so much related to the gene defect. Therefore, if you have gout in your family, you need to eat a light diet to reduce the incidence of gout. Can it be cured? Gout, like hypertension and diabetes, is a chronic disease that cannot be cured in principle, but can be controlled and treated early without affecting normal life and work or damaging the internal organs. For some patients with few attacks, short duration and mild disease, after proper treatment and diet control, some patients can never have gout again. Time is limited, so let’s talk about this first. I hope it will help you!