Gout treatment aims to address acute symptoms and prevent future gout attacks.
Gout is not an emergency condition, yet it makes people suffering from it feels like dying from the pain it causes, though not all but most of them.
Gout is a disorder in the ability of the body to handle uric acid. Uric acid is a by-product when purine is processed by our body. Purine is one of the nutrients that can be obtained from dietary intake. Some of foods that are high in purine are organ meats like the liver. Other sources are sardines, canned seafoods and anchovies.
In gout, there will be a notable increase of uric acid in blood (hyperuricemia) resulting to its deposition into the joints as uric acid crystals also known as urate. This accumulation of crystals keeps the joints swelling and painful also known as arthritis (joint inflammation). The inflammation is basically caused by the attempt of the immune system to eliminate the uric acid crystals. White blood cells would generally accumulate in tissues where urates are deposited to engulf and eradicate them. Consequently, the affected area becomes red, swollen and painful.
Specifically, the crystals will usually be deposited in the joint structure called bursae (the space within the joint where synovial fluid is located). The synovial fluid serves as joint lubricant for smooth joint movement. The crystals that become lumps around or within the joints and other tissues are actually called tophi. Apart from the joints, increased uric acid level may also affect the function of the kidneys and might even deposit within kidney tissues causing a condition called nephrolithiasis (kidney stone formation).
Male population is of higher risk to have gout compared to women. Gout would usually start manifesting after reaching puberty stage for men. It is more common and progressive at the age of 75 years old. For the female population, gout is common among women on their menopausal age.
Severe gout symptoms prompt affected individuals to seek for gout treatment. The common symptoms that will be experienced by people with gout are as follows:
1. Swelling of the joint in the big toe called podagra (most common)
2. Swelling of joints in the fingers, elbows, wrist, knees and ankles (gout attacks one joint at a time)
3. Redness around the joint
4. Tenderness on affected joints
5. Tophi formation (chronic)
Individuals with family history of gout are probably of higher possibility to inherit the said joint disorder. Gout can also be triggered by habitual alcohol intake, hypertension, obesity, kidney disorder, dehydration, joint injury, febrile conditions and can be medication-induced (tuberculosis medications such as ethambutol and pyrazinamide, diuretic like thiazide. All these factors may cause an increase in uric acid level.
Gout treatment including gout medication intake can’t immediately take course not until the condition is diagnosed. The following are diagnostic examinations to determine presence of gout:
Arthrocentesis is the aspiration of fluids from the joint. The joint fluid serves as a specimen to be checked for presence of uric acid crystals. This is done with the use of syringe and needle and is performed using the sterile technique. The specimen will be then evaluated by the Rheumatologists, doctors specialized in joint disorders.
Blood test is also significant to check for the level of uric acid in the blood. The normal uric acid level ranges 2.4-6.0 milligram/decilitre (female) and 3.4-7.0 milligram/decilitre (male). A uric acid level above the given range indicates hyperurecemia, which is common among people with gout.
X-rays of the affected joints can be performed as well to check presence of tophi (urate crystal deposits) and other bone or joint injuries that might have resulted from chronic gout.
Gout treatment is focused on alleviation of acute gout symptoms and prevention of future gout attacks. As mentioned earlier, gout is an inherited disorder and can be triggered by many factors. Gout treatment should get through the bottom of what had caused it.
Since gout becomes debilitating in the presence of severe symptoms, the usual management for this disorder is use of gout medications, particularly during acute stage. However, there are medications that also serve as maintenance drugs to avoid recurrent attacks of gout. The common medications prescribed by physicians are as follows:
Analgesic Medications (pain reliever)
Analgesic medications are used to relieve pain. Pain and tenderness are the most unbearable symptoms of gout. The most common pain reliever administered for gout is acetaminophen (Tylenol).
Anti-inflammatory are intended to reduce or totally eradicate inflammation of the joints. The common types of anti-inflammatory medications administered are as follows:
1. NSAIDs (non-steroidal anti-inflammatory drugs) such as indomethacin and naproxen
2. Colchicine can decrease both inflammation of joints and level of uric acid
3. Corticosteroids such as prednisone
Anti-gout Maintenance Medications
Anti-gout maintenance medications are drugs that are regularly taken by the affected individual to control and reduce uric acid level. These medications will prevent recurrent and future gout attacks by maintaining the uric acid level at the normal range. Common anti-gout medications administered are probenecid (Benemid), sulfinpyrazone (Anturane) and allopurinol. These medications are usually started after the acute attack of gout has been resolved.
Apart from drug administration, it is also important to integrate proper diet in gout treatment. Besides, one of the triggering factors of gout attacks is high purine intake in the diet. A person who is high risk for gout or has been suffering from gout should avoid or reduce intake of foods rich in purine such as sardines, meat organs like liver and other internal organs, legumes, canned seafood and anchovies. Weight reduction and decreased alcohol intake are other lifestyle modifications necessary to prevent gout. Besides, gout acute and future attacks can be controlled and the best way to achieve this is through following gout treatment regimen religiously.
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