Gout and Its Management

A new research indicates that the current health crisis in USA is Gout while previous were obesity and hypertension. Gout is most painful rheumatic disease effecting about 8.3 million people. Associated high uric acid rates in blood are affecting 43.3 million adults currently. This rate has been growing up every year.

What Is Gout?

Gout is a rheumatic disease characterized by deposition of needle like crystals (monosodium urate) of uric acid in tissues or joint spaces or both in the body. This disease affects big toes in major. In almost 75% patients, gout affects big toes (called as Podagra) in the course of disease. Others include instep, ankles, heels wrists, fingers and elbows. Pseudo gout is another rheumatic condition in which crystals of calcium pyrophosphate dihydrate deposit in joints, a condition also called as Chondrocalcinosis. 

Symptoms

It is associated with pain which causes swelling, redness and warmth over the joint. The joint gets extremely tender and touching or moving it can be so awfully painful. Joints might get stiffed. Also, the patient might feel fever, chills or lethargy.

Progression of Disease

It progresses in 4 stages.

Asymptomatic

It is associated with hyperuricemia. This is without any symptoms but the tendency is there to develop gout.

Acute Gout

It is characterized as sudden pain in joints. The joint gets tender, warm and swelled. The attacks occur mostly at night with the resting period of 3-10 days. The attacks may comeback after a month or so.

Intercritical Gout

It’s the period between the acute attacks and apparently no symptoms. Joint works normally but the hyperuricemia rests.

Chronic Gout

It is characterized as most disabling stage as it develops over 10 years period or more. The joint damage is permanent; however, proper treatment can prevent its advanced stage.

Pharmacological Treatment

The treatment includes:

NSAIDs: Indomethacin particularly, can treat the condition and the patient feels well in 4 hours. It is given for 1 or 2 weeks. It has lesser side effect profile than any other in the list like gastric bleeding, indigestion and stomach pain. Also, the toxicity profile gets higher after long term use.
Colchine is considered as an alternative to NSAIDs in alleviating attacks. But it also comes up with serious side effects profile like bleeding or bruising, numbness and diarrhea.
Steroids are known to use if the patient is contraindicated for NSAIDs. It has found to be effective if injected into the joint. However, joint infection should be noticed as it can worsen the condition.
Allopurinol is known to inhibit the uric acid production and has been considered as effective drug therapy along with uricosurics. They are used in combinations with NSAIDs or Colchine for the first 3-6 months of treatment. It should be given after 2 acute attacks, not later than that.

Natural Management

•    Meat is a source of increasing uric acid, so avoid consuming it.
•    Avoid coffee, caffeine, alcoholic beverages as they prop up dehydration which irritates the urinary tract.
•    Overweight gout patients should shed away excessive weight.
•    Consume water daily so that you are able to flush away the deadly crystals.
•    Try to take an enzyme from pineapple stem, Bromelain.

There is no complete cure for Gout, but keeping up with healthy behavior and diet plan, one can fight this up till long. Currently, many new medications (Anakinra, Canakinumab) and Gout management solutions are under study which may bring valuable fallout for gout patients.