Gout Treatment

Content

• Intercritical Gout
• What Is Gout?
• Arthritis
• Diet
• Meal Planner, Recipes & Diet For Gout

The exception to this is in an oncologic setting, in which patients receiving cytolytic treatment may receive prophylaxis against acute uric acid nephropathy. Uric acid increased accumulation and/or reduced excretion in human bodies is closely related to pathogenesis of gout and hyperuricemia. It is highly affected by the high intake of food rich in purine. Uric acid is present in both higher plants and microorganisms with species dependent concentration. Urate-degrading enzymes are found both in plants and microorganisms but the mechanisms by which plant degrade uric acid was found to be different among them.

A study shows that higher consumptions of coffee can reduce uric acid levels and prevent an onset. About 4-6 cups of coffee every day can greatly help with gout management. Alcohol, especially beer and hard liquor, raises uric acid level, which can lead to gout attacks. This is why so many people who drink an excessive amount of alcohol have gout attacks. Drinking wine occasionally does not seem to be linked to an increase in gout attacks. It is used together with urate-lowering therapy in patients with gout for whom urate-lowering therapy alone was insufficient in reaching normal uric acid levels.

Intercritical Gout

Current evidence supports an association between cherry intake and a reduced risk of gout attacks. Note however that we were unable to conduct effective meta-analysis due to a lack of relevant studies and a high degree of variation in the methodologies and metrics used in previous studies. Further comprehensive trials or long-term follow-up studies will be required to evaluate the efficacy of cherry intake in treating patients with gout or hyperuricemia.

Healthy body weight maintenance is another vitally important component of a well-rounded treatment plan for gout. In people who are overweight, weight reduction may help to limit the risk of recurrent gout attacks. For this reason, people with gout who are overweight should follow a weight-reduction plan, including a healthy, lower-calorie diet and aerobic exercise. For some suggestions about weight loss, see the article "Weight loss and arthritis" in the December 2006 issue of JointHealth™ monthly. The pain and swelling of gout are caused by uric acid crystals that deposit in the joint. Uric acid is a substance that normally forms when the body breaks down waste products called purines.

What Is Gout?

It is unclear whether dietary supplements have an effect in people with gout. One of the studies investigated the relationship between the ingestion of cherry extract and urate concentration levels. Two of the studies focused on the correlation between the incidence of gout attacks and cherry intake. Zhang et al. assessed the relationship between cherry consumption and the risk of recurrent gout attacks . They reported that after ingesting cherries for a period of two days, there was a significant decrease in the risk of gout attacks. Cherry juice and cherry extract produced consistent results across groups categorized by sex, obesity status, purine intake, alcohol use, diuretic use, and use of antigout medications.

Arthritis

Chronic lead exposure and lead-contaminated alcohol are risk factors for gout due to the harmful effect of lead on kidney function. High levels of uric acid in your body can cause several problems. It leads to the formation of solid crystals within the joints which causes a painful condition called gout. It may also cause kidney stones and lead to kidney failure in severe cases. The amount of uric acid in your body can be detected through a simple blood test and therefore, it's important to have regular check-ups. Finally, shedding a few pounds healthfully can help prevent gout.

Doctors know that gout occurs when uric acid crystallizes in a joint. Uric acid is a waste product that is formed when purines - crucial substances found in protein and other foods - are broken down. Under normal conditions, uric acid dissolves in the blood, passes through the kidneys, and is excreted in the urine.

What Is A Kidney Stone?

Throw in some low-fat dairy, fresh apples, a handful of whole grains and sunflower seeds for a potent drink. A review of data from the National Health and Nutrition Examination Survey found that in women, higher folate intake was associated with lower risk of hyperuricemia. In men, both higher folate and higher vitamin B12 intake were associated with lower risk. Adequate hydration is recommended to maintain a high urine output of at least 2 L daily, unless otherwise contraindicated for other medical conditions where volume overload may be a concern. Overall, febuxostat was as safe as allopurinol in the CONFIRMS trial. However, previous studies have identified cardiovascular events with febuxostat, and large ongoing trials are comparing the cardiovascular safety of febuxostat versus allopurinol.

Acute Gout Attack

This can culminate in sudden and excruciating joint pain, called an acute gout attack. In 2009, the FDA approved the use of a new xanthine oxidase inhibitor, febuxostat, for the treatment of hyperuricemia in gout. It has demonstrated a dose-dependent decreasee in serum uric acid . Its efficacy has been demonstrated in patients with mild or moderate renal impairment and gout. However, it can cause abnormalities in liver function tests and routine monitoring of bloodwork is recommended.

Urate-lowering medicines such as allopurinol may protect the kidneys from worsening kidney disease. However, the FDA has not approved this drug at this time due to risk for adverse effects. Anakinra, given as a daily injection, has been evaluated for treating difficult gout.

Insulin resistance is commonly associated with being overweight, and it causes uric acid levels to increase. However, its important to note that quick weight loss may actually trigger a gout attack, so focus on a lifestyle approach that allows for gradual, sustainable weight loss. Another recommendation often given to people with gout is to lose weight if needed. Studies show that weight loss can help lower uric acid levels and possibly prevent attacks. However, there is a need for more rigorous studies in this area, say researchers. “The diet was originally developed to lower blood pressure, but it also seems to lower the risk of gout,” says Dr. Brown.

Can uric acid be cured?

Patients can never be cured of gout. It is a long-term disease that can be controlled by a combination of medication to control the uric acid level, and anti-inflammation drugs to treat a flare-up.

There are many circumstances where, however ideal it would be, no fluid or other specimen is available to examine, but a diagnosis of gout needs to be made. A set of criteria has been established to help make the diagnosis of gout in this setting (see Table 1- Diagnosis of Gout When No Crystal Identification Possible). If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911. If you think you may have COVID-19, use the CDC’s Coronavirus Self-Checker. As a service to our readers, Harvard Health Publishing provides access to our library of archived content.

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