Creator: Dr. J Mariano Anto Bruno Mascarenhas
Published: 2016-08-22T11:35:40-04:00

Patient's Query

Hi doctor,

Since yesterday morning, I have been having an acute pain and stiffness in the joint of the big toe on the left foot. Also, there is a little amount of swelling. The symptoms are similar to elevated uric acid levels. Four years ago, I had a spike in uric acid levels. I have given my sample for a blood test. Can you suggest some medicine in the meanwhile?

Answer

Dr. J Mariano Anto Bruno Mascarenhas

Neuro Surgery Neurology Spine Health Spine Surgery

Hi,

Welcome to icliniq.com.

I have gone through your query with diligence and would like you to know that I am here to help you.

I suggest tablet Naproxen 500 mg twice daily and tablet Indomethacin 50 mg three times daily. These are generic names. Please consult your doctor, discuss with him or her and take the medicine with consent.

For further information consult a general practitioner online --> https://www.icliniq.com/ask-a-doctor-online/general-practitioner

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Patient's Query

Thank you doctor,

I have got my blood report today and I have attached the same here. The uric acid level is 8.7. I have the following queries. I have started taking Naproxen. Do I need to continue the same and for how many days? What food should I avoid and eat? Can I eat chicken or fish? Can you suggest any treatment to reduce the swelling and pain in the foot?

Answer

Dr. J Mariano Anto Bruno Mascarenhas

Neuro Surgery Neurology Spine Health Spine Surgery

Hi,

Welcome back to icliniq.com.

You have to take Naproxen for 7 to 10 days. By that time the swelling would have reduced.

You can eat chicken. But, avoid liver and kidneys, which can cause an increase in uric acid.

Increase your liquid intake, limitation of ethanol use, decreased use of fructose-containing foods and beverages and avoidance of diuretic are also helpful to limit uric acid level. Control of body weight is another important factor.

The mainstay of treatment during an acute attack is the administration of anti-inflammatory drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine or glucocorticoids.

Ice pack applications and the rest of the involved joints can be helpful.

The most effective drugs are any of those with a short half-life and includes Indomethacin, 25–50 mg thrice daily, Naproxen 500 mg twice daily, Ibuprofen 800 mg thrice a day, Diclofenac 50 mg three times a day, Glucocorticoids given IM or orally, for example, Prednisone, 30 to 50 mg per day as the initial dose and gradually tapered.

For a single joint or a few involved joints intraarticular Triamcinolone acetonide, 20 to 40 mg or Methylprednisolone 25 to 50 mg, have been effective and well tolerated.

Based on recent evidence on the essential role of the inflammation and interleukin 1β (IL-1β) in acute gout, Anakinra has been used and other inhibitors of IL-1β are under investigation.

For further doubts consult a general practitioner online --> https://www.icliniq.com/ask-a-doctor-online/general-practitioner

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