Health information

QUESTION: It is time you devoted some space to your readers with gout
This
is my problem which always strikes just when I think all is going well
Can
you please explain the workings of this disease for me?

ANSWER: Gout is a form of arthritis
It’s caused by an excess of uric acid
in the body
Everybody has some uric acid, but some people have too much.
Either they make too much or their kidneys don’t flush enough uric acid out
with their urine
As a result, the excess acid forms crystals, which tend to
collect in the joints, especially in the fingers and toes
A gout attack
occurs when these crystals cause pain, redness and swelling in the joint.
Generally, the first attack of gout will disappear by itself after no
more than two weeks
Another attack may occur shortly thereafter, or it may
not happen again for years
Left untreated, though, gout can cause
complications
As the uric acid crystals build up in the joints, they form
tophi (or deposits)
The crystals can also lead to kidney damage and kidney
stones
Therefore, it’s important to seek medical attention for gout.
Your doctor may check for gout via several techniques
For example, he
or she may want to draw some fluid out of the affected joint to check for the
presence of uric acid crystals
If that’s not possible, you may be put on a
trial course of medication
If the drug works, it rules out most causes of
your joint pain other than gout
Finally, the level of uric acid in your
urine may be tested
(If this is the case, for three days before the test
you’ll have to limit your intake of foods high in purines, substances that
turn to uric acid in the body.)
If a diagnosis of gout is confirmed, two types of medications can treat
the disease
Colchicine or nonsteroidal anti-inflammatory drugs (NSAID) are
often prescribed to relieve the pain and inflammation
These drugs will clear
up an attack of gout; however, they have no effect on future attacks
NSAIDs
take longer to relieve gout’s symptoms, but they have fewer side effects than
colchicine, which causes cramps, nausea, vomiting or diarrhea in 80 percent of
the people who take a full dose of it.
Other drugs go to work to lower the level of uric acid in your body,
thereby preventing future attacks
Allopurinol does this by reducing the
amount of uric acid you produce
Probenecid and sulfinpyrazone help your
kidneys clear uric acid out of your bloodstream
These drugs will also
dissolve any tophi you may have formed and prevent future complications such
as kidney disease
Some doctors feel that gout patients must take drugs that
lower uric acid levels indefinitely
However, other experts disagree
In
mild cases, the risk of long-term use of the drugs may outweigh the risk of
future gout attacks.
Besides taking your medication, there are a few things you can do to help
control your gout
Keep alcohol consumption to no more than one or two drinks
a day, avoid large amounts of foods high in purine (anchovies, bacon, salmon,
herring, turkey and veal, to name a few), cut back on red meat to no more than
two to three times a week (it’s also high in purines), drink at least two
quarts of liquid a day and avoid aspirin and other drugs that contain
salicylates, which can increase uric acid levels and reduce the effectiveness
of gout medications
Remember, though, you can’t cure gout with your diet;
for that you need medication.

The material contained here is “FOR INFORMATION ONLY” and should not replace
the counsel and advice of your personal physician
Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.

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