What Is Gout? Symptoms, Causes, Treatment, Medication, Diet, Remedies

Content

• Chronic Gout Treatment
• Before Taking Colchicine,
• Updates On Arthritis And Rheumatic Diseases You Need To Stay Informed About Your Health
• Natural Home Remedies For Gout
• Treatment Options
• Medications To Treat Gout Attacks

Optimum results are achieved if pharmacotherapy is begun as soon as possible, preferably within 12 to 24 hours of onset of pain . Gout can be caused by overproduction of uric acid (10% of cases) or lowered renal uric acid excretion (90%) . Rarer causes of gout are genetic purine metabolism disorders such as the Lesch–Nyhan syndrome . People who develop destructive arthritis related to chronic gout may be helped with surgery. Gout develops when too much uric acid accumulates in your bloodstream. This dissolved uric acid then comes out of the bloodstream and forms microscopic spike-like crystals in joints or soft tissues.

Is Onion bad for gout?

If you have gout, dishes like chopped liver and liver and onions are best avoiding, along with other organ meats like kidney, heart, sweetbread, and tripe, since they're high in purines.

You might reap these other benefits of drinking lemon water too. Making changes to your diet and lifestyle, such as losing weight, limiting alcohol, eating less purine-rich food , may help prevent future attacks. Changing or stopping medications associated with hyperuricemia may also help. The disease should be diagnosed and treated by a doctor or a team of doctors who specialize in care of gout patients.

Chronic Gout Treatment

Patients taking colchicine should avoid grapefruit and grapefruit juice. All sources of purines cannot and should not be eliminated. In African-American subjects, the primary endpoint was reached in 47% on febuxostat 40 mg/day, 68% on febuxostat 80 mg/day, and 43% on allopurinol. Similar rates were seen in subjects with renal impairment. Adverse event rates in both subgroups were comparable with those in the overall trial.

Before Taking Colchicine,

Excess niacin and vitamin A, in particular, may bring on an attack, she says. So always consult a physician before increasing your vitamin intake. If the affected joint is not too tender to touch, try applying a crushed-ice pack, says John Abruzzo, MD. The ice has a soothing, numbing effect. Place the pack on the painful joint for about 10 minutes. Learn how to ease the aggravating symptoms of this common ailment. Relieve inflammation with NSAIDS (nonsteroidal anti-inflammatory drugs).

Individuals should consult a qualified health care provider for professional medical advice, diagnosis and treatment of a medical or health condition. Gout treatment aims for a uric acid level of 6 mg/ dL or lower to dissolve or prevent crystals. Since it is hard to heal the skin after a tophus is removed, a skin graft may be needed. For this reason, we often try hard to manage the tophus medically.

Why Is This Medication Prescribed?

Gout crystals can form white bumps called “tophi,” which are often visible under the skin . Obesity, insulin resistance, high cholesterol, heart disease, hypothyroidism, and kidney disease can be associated with gout. Episodes of gout have been noted after injury or surgery, sometimes involving infection or the use of contrast for x-rays. Physical fitness seems to help with prevention of gout. All information contained within the Johns Hopkins Arthritis Center website is intended for educational purposes only.

This situation has been mimicked in more recent times when imbibers of “moonshine whiskey,” often made in radiators containing lead, developed a lead poisoning-associated gout (“Saturnine gout”). Excess body weight has also been associated with gout. The prosperous and overweight burgher with gout is a classical European image of the 19th century, but in reality gout affects those of all economic classes. Treatment of pain and inflammation can be achieved with NSAIDs, colchicine, or corticosteroids (systemic or intra-articular). The choice of which treatment is the right one for a particular patient should be made on the basis of the patient’s co-morbid medical conditions, other medications, and side effect profile.

Further studies from which conclusions can be drawn researching the optimum time to begin treatment for chronic gout would also be of practical interest. Can uric acid-lowering therapy be started as early as during an acute gout flare? To date, only one, single-center study with a total of 57 patients has addressed this question .

If gout is not treated, uric acid deposits called "tophi" (pronounced TOE-fye) can form over time as lumps under the skin. Gout that is not treated can also damage the affected joints. Low doses of colchicine or anti-inflammatory medications may be used for an acute attack. Follow up with a doctor after the acute attack has resolved to determine if it is necessary to start medications to lower the blood uric acid level. Collections of these crystals, complications known as tophi, can occur in the earlobe, elbow, and Achilles tendon , or in other tissues. However, tophi can be a valuable clue for the diagnosis as the crystals that form them can be removed with a small needle for diagnosis by microscopic examination.

Local injection of crystalline preparations of corticosteroid can be an excellent option if a person has a single joint gout attack. Formulations injected include methylprednisolone acetate (Depo-Medrol®), triamcinolone (Aristospan®), and betamethasone (Celestone®). Of these preparations, betamethasone lasts the shortest time in the joint of these preparations, but gout tends to be self-limited within a few weeks, in any case, so this option can be quite successful.

Diet modifications alone are rarely able to lower uric acid levels sufficiently to prevent accumulation of urate, but they may help lessen the triggers of acute gout attacks. To reduce the risk of a rebound flare, preventive treatment and initiation of a tapered course of corticosteroids over 10 to 14 days is recommended after resolution of symptoms. It is important to understand that these maintenance medications are used to lower the uric acid well below normal to prevent recurrent gouty arthritis attacks.

Treatment Options

Starting dose is at 500 mg to 1000 mg daily and increased to 1500 mg to 2000 mg as needed. Probenecid may precipitate renal stone formation and good oral hydration should be encouraged. Probenecid is contraindicated in patients with renal stones and in patients with urate nephropathy. Probenecid given inappropriately to patients with hyperuricemia due to overproduction of uric acid can cause renal stones and urate nephropathy.

Roddy E, Zhang W, Doherty M. Concordance of the management of chronic gout in a UK primarycare population with the EULAR gout recommendations. Jordan RW, Khan SA. The management of gout in primary care. Choi HK. A prescription for lifestyle change in patients with hyperuricemia and gout. After a first gout flare the patient should be informed of possible lifestyle changes. Patient education should be provided to improve compliance . Acute gout requires pharmacotherapy (nonsteroidal anti-inflammatory drugs, corticosteroids, or colchicine).

Medications To Treat Gout Attacks

When you have a gout attack, pain relief is your first goal. It’s important to call your doctor even if the pain has stopped. The uric acid buildup that triggered your gout attack may still be irritating your joints and could eventually cause serious damage, like joint destruction and kidney damage. You and your health care professional can decide what might be best to treat your gout attacks and help prevent future gout attacks. Be sure to share your thoughts with your health care professional.