Remedies for Gout

Remedies for Gout

Gout is a form of arthritis (joint inflammation), characterized by an inflammation of mostly joints in the big toe, ankle or knee. If you have a gout attack, you will suffer from intense pain, swelling, redness, local inflammation and inability of use the joint normally. Unfortunately, gout cannot be reversed. All you can do is to relief the symptoms of the disease and most effectively prevent the extreme painful attacks from happening.

What is gout?

The needle sharp pain felt in the joint is caused by needle sharp uric acid crystals. These crystals form when your blood has an excessive amount of uric acid that can’t be excreted by the kidney’s like it normally should. Uric acid is a compound of so called ‘purines’:

Remedies for gout prevention and during attacks

1. Acute attack treatment

The initial treatment aims to relief the symptoms of gout and to treat its causes. The following drugs can be used to reduce pain, swelling, redness and inflammation:

  • NonSteroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen, naproxen or indomethacin, which can help reduce the pain within 2 to 4 hours. You should avoid taking aspirin because it can abruptly increase uric acid levels and as such worsen the symptoms;
  • Colchicine made from the poisonous Autumn crocus: taken immediately when the attack is felt and from then onwards every hour until the pain subsides or until the poisonous side effects makes you nauseous

For people who can’t take colchicine due to its side effects, nor NSAIDs due to e.g. possible stomach ulcers, corticosteroids and ACTH will be administered:

  • Corticosteroids which will be taken orally or injected straight into the joint to reduce the inflammation extremely fast
  • ACTH will be injected and if needed repeated over several days.

When you’re diagnosed with gout and have an attack, you must take the following measures:

  • Don’t use the affected joint but only 24h after the gout crisis has passed;
  • Apply hot compresses in the area. If this does not help, you can try applying ice packs.

2. Treatment after the first attack has subdued

Any person who suffered a gout attack and does not follow a specific treatment is most likely to suffer from recurrent attacks of gout in the future. Thereby, the goal of the maintenance treatment is to decrease the uric acid levels and prevent recurrent episodes of gout.

Some people can control their uric acid levels by:

  • maintaining a normal weight,
  • adopting a proper diet,
  • avoiding alcohol (especially beer),
  • avoiding drugs that increase the blood’s uric acid concentration (like aspirin) and
  • avoiding drugs that decrease the uric acid elimination by the kidneys (diuretics that eliminate water fast without giving the kidneys the time to get rid of the uric acid)

Patients with no symptoms, but with high uric acid levels don’t need a specific treatment.

Most patients with gout need to take medication that lowers the uric acid level in the blood or increases the extraction of uric acid by the kidneys. In this case, the most recommended drugs are:

  • Agents that catalyze the elimination of uric acid from the kidneys like Probenecid (sold as Benemid or Probalan) and Sulfinpyrazone (sold as Anturane)
  • Allopurinol (sold as Zyloprim), which decreases the endogenous production of uric acid (since 2009 the FDA approved Febuxostat which is said to be safer than Allopurinol for people that suffer from kidney diseases)
  • Colchicine taken in small quantities is said to prevent attacks or at least to reduce its severity.

For people that don’t have any results with any of the above mentioned drugs, there exists an experimental intravenous medication taken every 2 weeks to lower the uric acid level in the blood called Pegloticase (sold as Krystexxa).

Do not self medicate but ask your doctor for advice: inducing a decrease of uric acid in your blood could cause a sudden attack as well, especially at the time when you are already having an attack.

3.Treatment after painful lumps appear

If you don’t treat gout for 10 years, it becomes a chronic disease, with recurrent symptoms. Most likely your joint will be disabled due to visible lumps around the joint formed by excessive uric acid deposits, causing frequent or constant joint pain.

In this stage, you must take specific medication, according to your doctor’s prescription, which usually consists of the aforementioned drugs, in variable amounts. In rare cases, surgical intervention is necessary in order to remove these tophi or uric acid crystals formations that accumulated in intra-articular and periarticular regions around the joint.

Summarized

The above are guidelines on the remedies for gout, but the treatment should be customized according to the patient’s gender, age, phase of the disease, overall state of health, medical history and other medications taken.

Decreasing your diet of purine rich food is recommended. Selfmedication however is not recommended: when taking gout drugs, do monitor your blood levels regularly (every few months or at least twice a year).