Treatment For Gout

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Gout is a condition characterized by painful inflammation of the joints. As a result of disrupted metabolic process, uric acid tends to accumulate in the body. Purine is one of the genetic components of the cell and some of the foods you eat. It is being metabolized by the liver and the waste products are in the form of uric acid. The body eliminates these wastes through the kidneys by filtering out the blood. However, if your body has too much uric acid or the kidney does not removes these wastes products it accumulates in the blood leading to hyperurecemia (excessive uric acid in the blood). When the concentration of uric acid in the body becomes too high, these substances can no longer be dissolved where it begins to form urate crystals in a form of needle-like solids and build up around (synovial fluid) or inside the joints commonly on the big toes. White blood cells will try to contain the uric acid crystals resulting in inflammatory response causing pain, warmth, redness and swelling of the affected joints.

Treatment for Gout based on the severity of attacks

Acute Gout
The severe joint pain starts suddenly and escalates quickly accompanied by stiffness of the affected area. The goal of treatment of acute gout attacks is to terminate pain, promote functioning and prevents disability.
 Non-steroidal anti-inflammatory drugs
Taking these drugs with food is advisable because of risks of gastric irritation.
• Ibuprofen
• Naproxen sodium

 Colchicine
An anti-gout agent that works by blocking the natural processes that cause swelling

Prednisone
This is a corticosteroid medicine that controls gout inflammation and pain which is usually prescribed to patients who can’t take either non-steroidal ant-inflammatory drugs or Colchicine. Side effects may include sugar level and blood pressure elevation.

Take these medicines as prescribed by the doctor as soon as you experience sudden attack. A higher dose is often needed to stop an acute attack and tapered down to a lower daily dose to prevent future attacks. The pain often relieved within twelve hours of starting treatment.

Intra-articular glucocorticoids this is indicated for severe pain if patient is unresponsive to the usual medications or if a person is unable to take certain medications due to other health problems. This is administered by injecting directly into the joints.

Chronic Gout
This is a repeated episode of pain and swelling usually involved more than one joint. If poorly treated, it may result to lumpy deposits around the joints called Tophi. These are nodules that can become infected causing more pain.

 Uric acid-Lowering drugs (Uricosorics)
• Allopurinol and Febuxostat
A drug classified as xanthine oxidase inhibitor that work by reducing uric acid production in the body.
• Probenecid
This drug works by acting on the kidneys to promote uric acid excretion.
• Pegloticase (injection)
This drug belongs in a class called PEGylated uric acid specific enzymes used to treat ongoing gout and works by decreasing the amount of uric acid in the body.

Hemodialysis
This works by removing waste products including through a dialyzing machine which can be considered as an efficient treatment for gout.

Surgery
This is indicated in cases of ineffective treatment by pharmacological means and there has been damage to the joint or surrounding area (i.e., nerve compression).

Home Remedies

Massage therapy
This is actually an ancient complementary therapy. It aims to enhance the body’s natural healing mechanism such as improving of circulation to the damaged joints and reduce stiffness as well as pain.

 Ice therapy
Application of ice pack has a marked effect on the joints in relieving swelling and pain. Studies have shown that cooling decreases crystal induced inflammation.

Diet and lifestyle modification to help prevent gouty attacks
• Reduce red meat, oily fish, internal organs, yeast and shellfish in the diet.
• Limit alcohol consumption especially beer.
• Limit caffeinated beverages.
• Regular physical exercise and losing weight (if patient is overweight).
• Drinking plenty of water.

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