Gout is a relatively common disease. Generally, the affected people are mainly concentrated in middle-aged and elderly people. Gout is actually a kind of stone, but the location of the disease is not in the digestive tract like other stones. It is located in the bones and joints, so it is very difficult to treat. So, can painkillers be used during general gout attacks?
The first step: drugs to relieve pain
I believe everyone is familiar with painkillers. The main analgesics used in acute gout attacks include: colchicine, nonsteroidal anti-inflammatory drugs, and glucocorticoids.
Usually the earlier the medication is taken during an attack, the better the effect. Patients who are taking these drugs for the first time must take them under the guidance of a doctor.
Colchicine
Colchicine is an effective drug for gout pain relief, but some friends have experienced side effects such as vomiting and diarrhea after taking it. This is mostly related to excessive dosage.
In the past, the usage of colchicine was to take 0.5mg every hour, and stop increasing the dosage until the pain is relieved or vomiting and diarrhea occur. However, studies have found that high-dose colchicine is equally effective as low-dose therapy, while low-dose therapy has significantly fewer side effects.
Therefore, we currently advocate a low-dose therapy with few side effects and no reduction in efficacy: 0.5 mg each time, once or twice a day, and the total daily dose does not exceed 1.5 mg.
And the effect is good when applied within 24 hours of onset, but patients with renal insufficiency should follow the doctor’s advice to adjust the dosage. In addition, colchicine and some drugs will interact with each other. If you are taking other drugs while taking colchicine, you should consult your doctor first.
Notes on the use of colchicine:
If vomiting, diarrhea and other reactions occur, the dosage should be reduced, and in severe cases, the drug should be discontinued immediately;
Bone marrow hematopoietic function Patients with insufficiency, severe heart disease, renal insufficiency and gastrointestinal diseases should use with caution;
Hemograms and liver and kidney functions should be checked regularly during medication;
Female patients should use it with caution during medication and Contraception is required within six months after stopping the drug.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Traditional nonsteroidal anti-inflammatory drugs often cause side effects such as gastrointestinal bleeding and kidney damage, including indomethacin , ibuprofen, etc.
The gastrointestinal adverse reactions of new NSAIDs are significantly reduced, and their efficacy is no less than that of traditional drugs. However, they may all have cardiovascular side effects, so patients with cardiovascular diseases should choose them carefully.
Such drugs should be taken after meals to reduce gastrointestinal side effects. Gastroprotective drugs can be used at the same time when stomach discomfort occurs.
Glucocorticoids
Glucocorticoids can quickly relieve pain and reduce joint congestion and edema, but they are easy to relapse after stopping the drug, so this drug is only used when gout symptoms are very severe and recurring. Patients with seizures should not use it for a long time.
Local intra-articular injection is more effective and has fewer side effects than oral administration. Therefore, when acute inflammation of gout is limited to 1 to 2 joints, it is best to choose local intra-articular injection of hormones.
In addition, it is best to use hormones in combination with colchicine to avoid recurrence after drug withdrawal; but try to avoid using them in combination with non-steroidal anti-inflammatory drugs to avoid aggravating the damage to the gastric mucosa.
The second trick: non-drug pain relief
When gout attacks, the use of colchicine, non-steroidal anti-inflammatory drugs or glucocorticoids can have obvious effects. But in addition to medications, the following six methods can also help relieve pain.
Local cold compress
When a gout attack occurs, you can use an ice pack or ice mineral water to apply cold compress to the painful joint for 20 to 30 minutes. Cold compresses can reduce local inflammation and pain.
Be careful not to apply hot compresses or soak your feet in hot water. Rising temperature will aggravate inflammation, edema, and make the pain worse.
Local cold compress can temporarily relieve pain. Friends with gout have reported that the pain becomes worse after cold compress. Therefore, it is best for everyone to decide whether to apply cold compress according to their own situation.
Drink more water
Drinking more water can produce more urine, take away more uric acid, and prevent urinary tract stones.
Normal people urinate an average of about 1.5L per day, but those with gout should ensure they drink more than 2L of water per day.
Low-calorie, alkaline drinks are very suitable for gout patients, such as soda water. Of course, those who don’t like soda water can also choose boiled water or light tea.
Raise the lower limbs
During a gout attack, there is usually edema in the painful area. Therefore, the principle of "water flows downwards" can be used to raise the lower limbs to reduce edema. For example, put a pillow under your feet when sleeping and shorten the time you stand when getting out of bed.
Don’t torture yourself with shoes
When a gout attack occurs, your joints are painful and swollen. Wearing another pair of shoes will make things worse. If some patients have to move around, they must wear a pair of loose shoes.
In addition, wearing socks is also important. If the weather is cold, you can also wear socks, but the socks should not be too tight.
Diversion of attention
Some friends lie still when gout attacks. Everyone knows this pain. But if you lie still in bed and only think about joint pain, and you are completely immersed in it, the pain will be obvious.
So when you have a gout attack, try to divert your attention, watch movies, talk more, and divert your attention.
Control your diet. There are two things you need to do to control your diet. One is to abstain from alcohol, and the other is to reduce the intake of high-purine foods. Alcohol and high purine intake will increase uric acid and affect the control of gout.
1. Gout dietary principles
1. Eat a light diet
Gout patients should pay attention to adjusting their diet and quit drinking, because alcohol can easily accumulate lactic acid in the body, which can easily The seriousness of gout, especially beer, contains ingredients such as hops that can easily trigger gout.
In addition, avoid eating high-purine foods to prevent uric acid from increasing.
2. The three highs in the diet should be strictly prohibited
The three highs in the diet are high fat, high protein, and high sugar. The diet structure of gout patients should be mainly carbohydrates, so that It can promote the smooth excretion of uric acid, thereby reducing the induction of gout.
3. Maintain ideal weight
For gout patients who are relatively obese, it is also very important to lose weight. You can do some moderate aerobic exercise to lose weight. Such as swimming, jogging, etc.
4. Drink a lot of water
For gout patients, they should increase the amount of water they drink, because a large amount of water can promote the excretion of uric acid, thereby reducing the symptoms of pain, but it must Note that boiled water or light tea is the best drinking water, and strong tea and coffee are not allowed.
5. Proper and reasonable protein supplementation
When adjusting your diet, you should not just eat light foods, but also supplement protein at any time to avoid malnutrition in the body.