How long does gout last with and without treatment?

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Gout is a form of inflammatory arthritis. The condition involves flare-ups of symptoms, which are periods during which the symptoms emerge or worsen. There is no cure for gout, and the condition can worsen over time without proper treatment.

Treatments focus on reducing symptom severity during a flare-up and preventing future flare-ups. Doctors typically aim to reduce the amount of uric acid in the blood, which contributes to gout symptoms.

According to Johns Hopkins Arthritis Center, a gout flare-up typically reaches its peak within 12–24 hours of the initial onset. However, this period will vary depending on the person’s response to treatment and their general health.

Treatment should lead the symptoms to return to normal within a few days of the flare-up.

As treatment shortens the duration of flare-ups, they typically last for about 7–14 days without it.

Treatment can also reduce symptom severity. A 2014 review of colchicine found that people using this treatment were 25% more likely to report a 50% reduction in pain during a flare-up than those receiving a placebo. However, colchicine can cause side effects, such as nausea, vomiting, and diarrhea.

Common symptoms during a gout flare-up include:

• intense joint pain with a sudden onset
• pain in one joint at a time, which may increase as the disease progresses
• painful, discolored, and swollen joints

The Centers for Disease Control and Prevention (CDC) note that gout is most common in the big toe but that it also frequently affects other joints, such as the knee, ankle, and other toes.

Treatment can reduce the severity and duration of a flare-up, but people can also take steps at home to manage the symptoms.

A person can manage a flare-up when it occurs and take steps to prevent future flare-ups.

During a flare-up, the American College of Rheumatology suggests treatments that include:

• Colchicine: Doctors commonly prescribe this medication at an early stage of the condition, but it can cause side effects, such as nausea and vomiting.
• Nonsteroidal anti‐inflammatory drugs (NSAIDs): These drugs, which include ibuprofen, reduce inflammation and pain.
• Corticosteroids: Doctors may offer these drugs to people who are unable to take NSAIDs.
• Anakinra (Kineret): Anakinra is a new biologic drug for gout.

A person should work with their doctor to determine the best medications for their situation. They should make the doctor aware of how well the medications are working and whether there are any side effects.

The Arthritis Foundation provides several tips for managing a flare-up, including:

• using ice on the joint
• drinking plenty of water
• avoiding alcoholic beverages
• using a cane
• reducing stress
• elevating the affected foot or limb
• avoiding high purine foods, such as red meat, sweetbreads, and shellfish

Learn what foods to eat on a low purine diet.

To avoid flare-ups in the future, the CDC recommends:

• protecting the joints as much as possible
• eating a balanced, healthy diet that avoids high purine foods
• staying physically active
• maintaining a moderate weight
• working with a doctor to determine the best treatments and create a management plan

Diet can affect the symptoms of gout.

The CDC, the Arthritis Foundation, and the American College of Rheumatology recommend eating a diet low in purines. This means avoiding:

• red meat
• organs
• certain types of seafood
• alcohol

The DASH diet and Mediterranean diet are both good options for avoiding high purine foods.

The DASH diet primarily involves fruits, vegetables, whole grains, and lean meats, while the Mediterranean diet is rich in vegetables, whole grains, fish, and unsaturated fats.

Anyone who experiences an episode of gout symptoms for the first time should speak with a doctor. The doctor can help the person determine the best course of treatment, which is likely to include dietary changes and home remedies.

It is worth contacting a doctor if the recommended treatments are causing side effects or not working. In these cases, doctors can adjust the treatment plan accordingly.

A person with gout should also talk with their doctor if their gout flare-up is lasting longer than usual or the symptoms are worsening.

Gout flare-ups are painful episodes that can last for 1–2 weeks. Timely treatment can reduce the duration of a flare-up and the severity of the symptoms.

People with gout can take steps to prevent flare-ups, such as avoiding foods that are high in purine. Doctors can work with a person to determine an effective treatment plan that allows them to manage the disease over time with medications and lifestyle adjustments.