1.What is gout? Gout is a type of arthritis. It can cause pain and swelling in the joints. At first, it tends to affect only one joint, most often the big toe. People who have too much uric acid in their blood are prone to gout. Uric acid is a chemical produced by the body when it breaks down certain foods. Uric acid can form sharp, needle-like crystals that build up in the joints and cause pain. Uric acid crystals can form in the tubes that carry urine from the kidneys to the bladder, and these crystals can turn into “kidney stones” that can cause pain and poor urine flow. 2.What are the symptoms of gout? Patients with gout experience sudden onset of severe pain, often in the big toe, ankle or knee. The affected joints often become red and swollen. Usually only one joint is affected, but some people have pain in multiple joints. The pain of gout can be very intense. Pain and swelling are the worst at the beginning of an acute attack of gout. Within a few days or weeks, the symptoms will improve. The mechanism of how the body “shuts down” an acute attack of gout is not known. 3. Is there a test for gout? Yes, there is. A health care provider can take a sample of fluid from a painful joint, and if typical gout crystals are found in it, you have gout. But even without a joint fluid test, the doctor or nurse may still have a high suspicion of gout if: (1) you have a joint that is painful and swollen, especially at the base of the big toe; (2) your symptoms disappear completely between attacks, at least after your first attack; (3) your blood test results show high uric acid. 4. How is gout treated? There are several medications that can reduce the pain and swelling caused by gout. When you find a medication that works for you, keep it with you at all times. You can take it instantly when you feel an attack coming on. Gout medications work best if taken as soon as possible when symptoms begin. 5. Medications used to treat gout attacks include: Non-steroidal anti-inflammatory drugs (NSAIDs) This is a large group of medicines that includes ibuprofen and indomethacin. They may not be safe for people with kidney, liver or bleeding disorders. (1) Colchicine: This drug helps with gout, but can also cause diarrhea, nausea, vomiting, and abdominal pain. Doctors and nurses usually use this drug for people who cannot take NSAIDs. (2) Steroids: If you can’t use NSAIDs or colchicine, your doctor or nurse may recommend steroid medications. These are not the kind of steroids athletes use to strengthen their muscles, but are used to reduce swelling and pain. Administration methods include injections or pills. 6. Is there any medication to prevent gout attacks? Yes. There are medications that can reduce the chance of a gout attack, and many people with recurrent gout attacks need medication to prevent them. These medications generally work by reducing the amount of uric acid in the blood, such as allopurinol, febuxostat, and probenecid. People with severe gout can also get an intravenous injection of a drug called pegloticase (trade name Krystexxa), but some people may have an allergic reaction. If you take a certain medication to prevent a gout attack, your health care provider may emphasize the safety of its use, and they will check to see if your uric acid levels are low enough for the crystals to dissolve. When you first use allopurinol, febuxostat and probenecid, it often actually increases gout attacks. To prevent such attacks, your healthcare provider may have you use a low dose of colchicine at the same time. This allows time for the gout crystals to dissolve, which will stop a gout attack. 7. Is there anything I can do to prevent a gout attack? Yes. If you are overweight, losing weight can help relieve gout. In addition, you can change your diet to prevent gout attacks. You should eat less: red meat and seafood, alcohol such as beer, wine and spirits, foods and drinks with high fructose grain syrups (including most sodas, cakes and cookies) Instead, you should eat more low-fat dairy products, such as low-fat milk, cheese and yogurt whole grains and vegetables.