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[QUOTE="WisePig, post: 4329756, member: 1504"]
Gout is most often triggered by Purine rich foods like organ meats, seafood, beer, greens, lentils,  gravy.  Minor trauma and starting/stopping Allopurinol can also trigger an attack.   There is also a link between taking Hydrochlorothiazide diuretics and gout attacks.

The problem with bloodwork is that the uric acids level spike before the attack and by the time the attack occurs the levels are frequently just mildly elevated or back within the normal limits. The history of sudden onset of a red hot swollen and very painful joint is most important in the diagnosis.  A joint aspirate with microscopic examination using polarized light can also confirm the diagnosis but the joint aspiration would be extremely painful.

Treatment for acute attacks are usually oral prednisone, Indocin or Colchicine.  Each has its own problems.  Colchicine causes diarrhea, Indocin has to be taken with food to avoid stomach problems and oral Prednisone will shoot your glucose levels way up if you have diabetes.  Long term management tends to mostly be Allopurinol which blocks the production of uric acid but Probenecid should actually be prescribed if the true cause is under excreting Uric acid.
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