Gout Treatment, Diet, Cause, Symptoms, Definition & Medication

Content

• How Can I Protect My Kidneys And Lower My Risk For Gout Flares?
• How Does A Doctor Diagnose Gout?
• Treatment Overview
• Signs And Symptoms

Consumption of vegetables and low-fat or nonfat dairy products should be encouraged. The use of loop and thiazide diuretics can increase uric acid levels, whereas the use of the angiotensin receptor blocker losartan increases urinary excretion of uric acid. Reduction of uric acid levels is key to avoiding gout flares. Patients receiving urate-lowering medications should be treated concurrently with nonsteroidal anti-inflammatory drugs, colchicine, or low-dose corticosteroids to prevent flares. Treatment should continue for at least three months after uric acid levels fall below the target goal in those without tophi, and for six months in those with a history of tophi. If your gout is severe, prolonged, or chronic, you may need to take daily serum uric acid-lowering medication to reduce your uric acid levels.

NSAIDs, particularly aspirin and similar medicines, reduce the effectiveness of uricosurics. Patients taking uricosurics should avoid NSAIDs if possible. Certain medicines can interact with colchicine such as some antibiotics and stomach acid reducers .

How Can I Protect My Kidneys And Lower My Risk For Gout Flares?

In patients who are healthy, initial therapy with an NSAID or oral colchicine is acceptable. In patients with renal insufficiency (serum creatinine 2 mg/dL or creatinine clearance 50 mL/minute), prednisone 30 to 60 mg/day may be appropriate. Intraarticular corticosteroid therapy should be considered when a single joint is affected. Treatment with oral agents is usually tapered with symptomatic improvement and can be discontinued within 2 weeks in most cases. Urate-lowering drugs should not be started until after the acute attack has completely resolved. There are several main types of medications used in the treatment and management of gout.

Do tomatoes cause gout?

Foods and drinks that often trigger gout attacks include organ meats, game meats, some types of fish, fruit juice, sugary sodas and alcohol. On the other hand, fruits, vegetables, whole grains, soy products and low-fat dairy products may help prevent gout attacks by lowering uric acid levels.

Gout is a treatable condition, and the uric acid level can be decreased by medication and lifestyle changes. Talk to your healthcare provider about medications that can reduce uric acid levels. They can also discuss changes you can make to your diet and lifestyle to prevent and reduce gout attacks. The diagnosis begins with a history of your symptoms and a physical exam.

How Does A Doctor Diagnose Gout?

Colchicine may also be used either po or by IV and may produce substantial pain relief if started immediately after onset of symptoms. Supplementary analgesics may also be recommended along with rest, elevation, and joint protection strategies. NSAIDs are given to treat the pain, inflammation, and swelling caused by gout attacks. Some can be purchased over the counter or your doctor may prescribe a higher dosage. They work by decreasing prostaglandins, hormones that produce inflammation and pain.

Both colchicine and NSAIDs can be used during an acute gout attack to decrease inflammation and pain. Corticosteroids such as prednisone, methylprednisolone , and prednisolone , also can be used during an acute gouty flare. However, the total dose of steroids is generally limited due to potential side effects such as cataract formation and bone loss. Steroid medications are extremely helpful in treating gout flares in patients who are unable to take colchicine or NSAIDs. Gout is caused by too much uric acid in the bloodstream and accumulation of urate crystals in tissues of the body. Uric acid crystal deposits in the joint cause inflammation of the joint leading to pain, redness, heat, and swelling.

National Institutes Of Health

For example, it can resolve an attack of gout, but it doesn't help a flare-up of rheumatoid arthritis. If the level of colchicine builds up too high, as it might if a usual dose is given to a patient with severe kidney disease, toxicity can occur, such as suppression of the production of blood cells. In the past, colchicine was also used intravenously in addition to its oral use. For this reason, intravenous colchicine is very rarely used today.

Your Physical Therapist can advise you on when you should use a walking aid such as a cane/stick to assist your gait. Your therapist will also ensure that once your gout flare-up subsides that you are walking well and that you haven’t developed any poor long-term walking habits. In some cases of gout when the joint flares up, treatment with a Physical Therapist at Sports Rehabilitation Unlimited can be helpful in conjunction with medication.

These include pain relievers, medications to reduce inflammation, and medications used between flare-ups of disease activity to prevent future attacks. It is important to note that people with gout may be advised not take medications containing acetylsalicylic acid (ASA, Aspirin®), as these may decrease or prevent the kidneys' excretion of uric acid. Of course, if ASA is required for other medical reasons, it may still be used. Other medications that typically worsen gout include certain water pills or diuretics .

The presence of tophi indicates tophaceous gout and treatment with medications is necessary. Asparagus, beans, some other plant-based foods, and mushrooms are also sources of purines, but research suggests that these do not trigger gout attacks and do not impact uric acid levels. This stage is the period in between attacks of acute gout. Subsequent flares may not occur for months or years, though if not treated, over time, they can last longer and occur more frequently. During this interval, further urate crystals are being deposited in tissue.

This summary is provided to assist in informed clinical decisionmaking. However, reviews of evidence should not be construed to represent clinical recommendations or guidelines. Drinking lots of water is the best way to flush uric acid out of your system. During a gout attack, drinking 16 8-ounce glasses of water daily is recommended. To keep uric acid levels low to prevent attacks, stay hydrated with at least eight glasses of water a day. Other complementary drugs may be used in gout treatment, including Cozaar , an antihypertensive drug, and Tricor , a lipid-lowering drug.

How do you flush uric acid?

Gout can be extremely painful and incapacitating but is extremely treatable in almost all patients. It's important to identify and treat it early to avoid pain and complications. Gout is a major problem in the foot, but it can also involve many other joints.

The diagnosis of gout is usually confirmed when uric acid crystals are identified in a sample of a tophus or in joint fluid removed with a needle and viewed under a special microscope with polarized light. However, a strict low-purine diet lowers the uric acid level by only a small amount. In past times, when meat and fish were scarce, gout was considered a rich person’s disease. One lifestyle change is to get moving and take care of yourself. Excess body weight leads to increased production of uric acid.

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. Obesity can be linked to high uric acid levels in the blood.

Who's Affected By Gout?

The cytokines bring in more white cells, and on it goes. Vitamin C decreases uric acid levels and can help prevent gout attacks. Since fruit also contains fructose, which is linked with increased uric acid levels, opt for lower-fructose options. Grapefruit, oranges, pineapples and strawberries are high in vitamin C, but lower in fructose.