What is Gout & How is it Treated

Gout is a form of inflammatory arthritis marked by painful and swollen joints. It is characterized by pain, swelling (edema), redness and “heat” felt in the area, and loss of function (stiffness) of the joint.  The cause of gout is hyperuricemia (excess uric acid in the blood). Hyperuricemia is often asymptomatic and causes no complications; most people with high sanguine uric acid never develop gout.

The goal of gout treatment is to reduce pain as quickly as possible and long-term prevention of recurrence of seizures and complications such as joint destruction and kidney stones.  The Gout treatment is divided into two stages.

Stage 1:

– Reduction of acute pain (caused by inflammation of the joints) by administering anti-inflammatory drugs or corticosteroids:

NSAIDs (non-steroidal anti-inflammatory) such as ibuprofen or naproxen are usually prescribed to treat attacks of gout with sudden and severe nature. They usually reduce inflammation and pain within a few hours.

A doctor for people who cannot take anti-inflammatory drugs may prescribe corticosteroids, which are also called steroids. Steroids also act by reducing inflammation. Steroids can be injected into the affected joint or given in pill form.

Colchicine is often used to treat gout and usually begins working within a few hours after dosing.

Stage 2:

To prevent recurrent attacks the gout treatment includes the following:

– Weight loss (in patients with gout, overweight) and maintaining a healthy weight – It is useful for this purpose taking a lipid-lowering diet (low fat). However, a low-calorie diet can increase uric acid concentration in the blood and may eventually trigger a gout attack.

– Avoid alcohol, because it inhibits the renal excretion of uric acid, thus facilitating its accumulation in the body. Beer, which is high in purines, can be considered more harmful than other types of alcohol.

– Avoid diets rich in meat and seafood diets (foods high in purines), which can increase blood uric acid concentration

– Taking certain medications can decrease the renal excretion of uric acid to facilitate its accumulation in the body. These medications include diuretics (which remove excess water and salt from the body), administration of niacin or aspirin. It is important that any patient with gout see a doctor before use of complementary medical treatments

– Regular exercise and avoidance of sedentary lifestyle is important.

Any person who has had a gout attack and does not follow any gout treatment has a high risk of developing recurrent attacks of gout in the future. The goal of maintenance therapy is to lower blood uric acid and prevent recurrent attacks. It is also important to identify the cause which led to increased levels of uric acid (hyperuricemia).

Gout attacks are likely to occur during the administration of specific hipouricemiate medications.  In this case is not recommended to interrupt the gout treatment during the attack.

In patients with gout who were prescribed a specific treatment (probenecid or allopurinol), but have not followed the treatment, have a high risk of relapse of symptoms. In this case, the medication is not recommended until after delivery of the attack.

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