Managing Gout During Early Pregnancy: Seeking Relief and Guidance

I am currently in the early stages of pregnancy, but I am experiencing recurrent gout attacks?

Hello doctor, I would like to ask about my situation.
I have a history of gout and was previously on medication to manage it.
However, after finding out I was pregnant, I stopped taking the medication.
During my pregnancy, I have been experiencing frequent gout flare-ups.
I previously visited a doctor at Mackay Memorial Hospital, who prescribed antibiotics and pain relievers for me.
The doctor mentioned that they could only prescribe those medications twice and could not provide any more due to the potential harm to my baby and myself.
However, my gout has not improved, and the pain is unbearable; I can hardly walk.
What should I do, doctor?

Meng Yu, 30~39 year old female. Ask Date: 2018/02/27

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have a history of gout and was previously managing it with new medication.
However, after I found out I was pregnant, I stopped taking the medication.
During my pregnancy, I have been experiencing frequent gout flare-ups.
I previously consulted a doctor at Mackay Memorial Hospital, who prescribed me antibiotics and pain relievers.
The doctor mentioned that they could only prescribe these medications twice and could not provide further prescriptions due to the potential harm to both the baby and me.
However, my gout has not improved, and the pain is now severe, making it difficult for me to walk.
What should I do, doctor?
Answer: Please schedule an appointment at the high-risk pregnancy clinic at Mackay Memorial Hospital (such as with Dr.
Huang Min-Chao).

Reply Date: 2018/02/27

More Info

Managing gout during early pregnancy can be quite challenging, especially since many medications used to treat gout are contraindicated during pregnancy. Gout is a form of inflammatory arthritis characterized by sudden and severe pain, redness, and swelling in the joints, often affecting the big toe. It is caused by elevated levels of uric acid in the blood, which can form crystals in the joints.

In your situation, it is understandable that you are concerned about managing your gout while ensuring the safety of your developing baby. The first step is to communicate openly with your healthcare provider about your symptoms and the severity of your gout attacks. While it is true that many gout medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine, are not recommended during pregnancy, there are still some strategies you can consider to manage your condition.

1. Dietary Modifications: One of the most effective ways to manage gout is through dietary changes. Avoid foods high in purines, which can increase uric acid levels. These include red meats, organ meats, shellfish, and certain types of fish. Instead, focus on a diet rich in fruits, vegetables, whole grains, and low-fat dairy products. Cherries, in particular, have been shown to help reduce uric acid levels and may be beneficial for gout sufferers.

2. Hydration: Staying well-hydrated is crucial. Drinking plenty of water can help dilute uric acid levels in the blood and promote its excretion through the kidneys. Aim for at least 8-10 glasses of water a day, unless otherwise advised by your healthcare provider.

3. Weight Management: If you are overweight, losing weight can help lower uric acid levels and reduce the frequency of gout attacks. However, it is important to approach weight loss cautiously during pregnancy. Consult with your healthcare provider for a safe and effective weight management plan.

4. Rest and Elevation: During a gout attack, rest is essential. Elevating the affected joint can help reduce swelling and pain. Applying ice packs to the affected area may also provide temporary relief.

5. Alternative Pain Relief: While traditional pain medications may not be safe during pregnancy, you can discuss with your doctor the possibility of using acetaminophen (Tylenol) for pain relief, as it is generally considered safe during pregnancy. However, always consult your healthcare provider before taking any medication.

6. Regular Monitoring: Regular check-ups with your healthcare provider are essential to monitor both your gout and your pregnancy. If your symptoms worsen or if you experience severe pain that interferes with your daily activities, it is important to seek medical attention promptly.

7. Consult a Specialist: If your pain is severe and unmanageable, consider asking your healthcare provider for a referral to a rheumatologist who specializes in gout management. They may have additional insights or treatment options that are safe during pregnancy.

In summary, managing gout during early pregnancy requires a careful balance of dietary changes, hydration, rest, and communication with your healthcare provider. While it can be frustrating to deal with flare-ups, especially when medication options are limited, focusing on lifestyle modifications can help alleviate symptoms and promote overall health for both you and your baby. Always prioritize open communication with your healthcare team to ensure the best possible outcomes for your pregnancy and your gout management.

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