Goutoften referred as ‘metabolic arthritis’ is formed due to the formation of uric acid. It causes inflammation and pain in one or more joints.
Treatment of Gout
Treatment of gout involves two things. First the joint inflammation caused due to gout should be treated. Second is the prevention of future attack of gout which is as important as curing the acute arthritis.
First, the pain killers like acetaminophen and other analgesics are used to relieve pain. Secondly, anti inflammatory medicines like NSAIDs, corticosteroids and colchicines are used in reducing joint inflammation. Finally, the chronic metabolic derangement which causes gout and hyperuricemia are cured with medications.
Non Steroidal Anti Inflammatory Drugs (NSAIDs) like Indocin (indomethacin), Naprosyn (naproxen) are the commonly used anti-inflammatory medicines used for treating gout.
These medicines are gradually tapered as gout starts curing. If you have an allergy history to nasal polyps or aspirin, avoid taking NSAIDs. It may cause acute allergic reaction called as ‘anaphylactic reaction’.
Colchicine also referred as colcrys is administered through mouth for curing inflammation and preventing arthritis gouty attacks. Hyperuricemia is reduced with medicines Zyloprim (allopurinol) or Uloric (febuxostat). For acute cases, it is prescribed even on an hourly basis until the pain is reduced or until patient exhibits gastrointestinal effects like diarrhoea.
Corticosteroids like prednisone, prescribed for short courses are anti inflammatory medicines for curing acute gout. They can be given orally or injected into the affected joints.
Corticosteroids are advised for patients with liver, kidney or other gastrointestinal complexities.
Medicines for Controlling Uric Acid Level
Apart from taking medications for gout attacks, drugs are prescribed for prolonged period of time to lower uric acid level of blood. Uric acid of blood should be brought down to lower the chances of recurrent attacks of kidney stones, arthritis or other kidney diseases. The tophi deposits should be gradually dissolved.
Medicines for reducing blood uric acid, works in two ways. It either improves the uric acid excretion by kidney or reduces uric acid production from purines of food. These medicines should only be started after the inflammation due to gouty arthritis has dropped considerably.
Drugs such as Benemid (Probenecid) and Anturane (sulfinpyrazone) are widely used to reduce blood level of uric level by improving the uric acid excretion to urine. If you have a history of kidney stones, it’s better to avoid these medicines. When you are taking these medicines, keep yourself well hydrated to avoid formation of kidney stones. Fluid intake encourages rapid flow of uric acid from the urinary system and discourages kidney stone formation.
Febuxostat is used for the treatment of acute gouty arthritis. Febuxostat is found to be more efficient than allopurinol for treating gout and in shrinking deposits of tophi in uric acid. Tophi deposits are found in the tissues of ears, elbows and fingers. As febuxostat is not metabolized by kidney unlike allopurinol, it can be used by patients having kidney disease.
Eat at least one apple every day. Citric acid found in lime is a uric acid solvent, which is an excellent remedy for gout. Mix lemon juice with water in 1:1 ratio and drink it twice daily. Juices of carrot, beetroot and cucumber should be taken once a day.