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

Content

• Health & Wellness
• How Can I Manage A Gout Attack?
• Whats The Outlook For People With Gout?
• More Health News + Info
• Nonsurgical Treatment
• Cleveland Clinic Menu

As always you should drink plenty of fluids, especially water. Drugs can lower blood levels of uric acid by decreasing the body’s production of uric acid or increasing the excretion of uric acid in the urine. The lower the blood uric acid level, the faster the deposits will dissolve.

Here, there was no difference in death rates in patients on febuxostat compared to those on allopurinol. This trial actually had many fewer dropouts in the study and overall reviewers have felt that the FAST trial is a more solid base than the CARES trial on which to base decisions about the use of febuxostat. Some have called for the FDA to reconsider its recommendations, but no changes made to date.

Health & Wellness

When gout causes severe joint pain, it is called a gout attack, a gout flare-up, or acute gout. Pain is typically accompanied by extreme joint tenderness, swelling, warmth, and skin redness. Uric acid comes from the breakdown of substances called purines. Purines are in your body's tissues and in foods, such as liver, dried beans and peas, and anchovies.

The sooner you start treatment, the sooner your pain will go away. NSAIDs and colchicine are first-line treatment for gout. Corticosteroids are only used if NSAIDs show no improvement or are contraindicated. Being overweight causes your kidneys to work harder to excrete the increased amount of uric acid produced. You may not be able to move your joints properly once you develop gout. Affected joints may experience discomfort for days to weeks after the most severe pain stops.

How Can I Manage A Gout Attack?

Prednisone can be given at a dose of approximately 40 mg for 1-3 days, which is then tapered over approximately 2 weeks . If treatment continues for more than 2 weeks, consider measures to prevent osteoporosis. To control the acute attack, NSAIDs are prescribed at full dosage for 2-5 days. the dosage is reduced to approximately one half to one fourth of that amount. Gout symptoms should be absent for at least 2 days before the NSAID is discontinued.

However, the effect was small--only a drop in blood uric acid level of about 0.5 mg/dL, and almost all gout patients need to come down more than this to get to the goal of less than 6.0 mg/dL. Based on the data, the result is likely not going to be sufficient. It is not approved for use in people with significant decrease in kidney function, and some patients have had worsened kidney function while taking lesinurad. Kidney function is thus checked before and during treatment.

This is because the surgery itself raises the risk of developing gout, as does the medicine cyclosporine used to prevent rejection of the transplanted organ. Cyclosporine also interacts with indomethacin, a common gout medicine. When gout remains untreated, the periods between attacks of acute gout become shorter and shorter and the attacks, although sometimes less intense, can last longer. In about 10 to 20 years gout becomes a chronic disorder with constant low-grade pain and mild or acute inflammation.

Is chocolate good for gout?

Eggs are a good protein source for people with gout, because eggs are naturally low in purines.

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Patients’ perception about their illness, professional knowledge and perception and societal perceptions of gout all act as important determinants of the decision to seek treatment. Other non-pharmacological approaches should be used as adjuncts to urate-lowering treatment in gout. Misconceptions about gout are prevalent among both patients and doctors.

The time between flares is referred to as the inter-critical period. There is another study about Electroacupuncture combined with local blocking therapy on acute gouty arthritis that shows an improvement in health status of the patients. This treatment is positive and it also decreases blood uric acid levels. During the acute or early phase of a gout attack, doctors prescribe medicines called colchicine, certain nonsteroidal anti-inflammatory drugs , and corticosteroids to decrease swelling and relieve pain. The sooner they are given after an attack starts, the faster the pain goes away.

Nonsurgical Treatment

People with hyperuricemia with no symptoms might be coached to make lifestyle changes — losing weight would often top the list — but hyperuricemia by itself is usually not treated. Non-steroidal anti-inflammatory agents and COX-2 inhibitors are the mainstay of therapy of acute attacks of gout in patients who have no contra-indication to them. These medications include such agents as naproxen (Naprosyn®), ibuprofen (Motrin®), celecoxib (Celebrex®), indomethacin (Indocin®) and many others. These agents reliably decrease the inflammation and pain of gout. However, patients with ulcers, hypertension, coronary disease, and fluid retention must be careful with these agents, even for the short courses (usually 3-7 days) needed to resolve a gout attack.

The medication may also be taken in smaller doses to help prevent attacks in those with recurrent gout attacks who are started on urate-lowering medications. They should be taken at the same time each day and should be taken with food or liquid to help avoid stomach upset. Xanthine oxidase inhibitors are sometimes given to people who suffer repeated gout attacks. This medication slows the development of uric acid by inhibiting the activity of certain enzymes. It's given in tablet form and should be taken at the same time each day.

The medical term for excessive fluid in a joint is a "joint effusion." Doctors place gout under the umbrella term “arthritis” — a broad range of joint diseases and joint pain. Some forms of arthritis inflame joints, while others don’t.

Can Gout Be Prevented Or Avoided?

The medication can be given as a tablet or in liquid form or by injection into a joint—or in severe cases, as an IV. If taken orally, corticosteroids are best taken at the same time each day and should be taken with liquid or food to lessen stomach upset. Losing weight too rapidly can occasionally precipitate gout attacks. AllopurinolThis medication decreases the formation of uric acid by the body and is a very reliable way to lower the blood uric acid level. Allopurinol is currently the gold standard of maintenance therapy. If one has been diagnosed with gout and has had more than one attack of arthritis, take the medication prescribed by a physician for these attacks.

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The goals of treatment are to relieve pain, shorten the duration of inflammation during an acute attack, prevent future attacks and prevent joint damage. Your doctor may check for other types of arthritis such as CPPD deposition disease and infectious arthritis. These conditions resemble gout but are not caused by uric acid crystals. To determine which type of arthritis you might have, your doctor may have to remove fluid from an affected joint and examine it for crystals. Treatment for gout focuses on relieving pain during acute attacks, preventing future gout attacks, and reducing the risk of developing tophi and permanent joint damage.