In the following video, a doctor of rheumatology from the NHS (Nation Health Service, UK), explains what gout is, it's causes, and standard gout treatments:
Gout Treatments: As explained in the video
Gout is a recurrent painful arthritis - probably the most painful arthritis we know. It predominantly effects males in their 40s. It is associated with a number of conditions, such as obesity, high alcohol consumption, high lipids in the blood, and probably some genetic factors which are not yet well-understood.
The major problems with gout are:
The acutely painful arthritis itself. The typical onset of gout involves waking at 3 or 4 am, with excruciating pain, usually in the big toe or ankle. The pain is so intense that you can not even bear to lay a bed sheet over the affected area. It is that exquisitely painful and tender.
There is a range of associated metabolic diseases that tend to come with gout, so gout is a warning to the patient to examine a set of lifestyle issues, beyond the gout itself.
Gout often starts in a big toe or ankle, but over time it can also affect knees, wrists, hands, and elbows. In addition gout can result in hard deposits of crystals in the joints and under the skin. So you can get lumps on your elbows, for example, or little white crystals in you ears.
The management of gout involves the management of lifestyle factors, along with treatment of acute and chronic attacks.
Life-style factors for reducing gout include:
Weight loss
Reducing alcohol intake - especially beers, which are more prone than wine to - causing gout
Reduction in shellfish and meat intake, which are associated with high levels of uric acid after digestion
Checking levels of blood pressure, cholesterol, triglycerides (fat in the blood)
Treatment of acute gout, generally involves drug treatments. The most common drugs used to treat gout are non-steroidal anti-inflammatory formulas, such as Ibuprofen. Colchicine, which is an older drug is also used to treat gout. (See colchicine side-effects at http://en.wikipedia.org/wiki/Colchicine#Side_effects.)
Another treatment that can be useful for people who cannot tolerate anti-inflammatories and colchicine, and both have significant side-effects, is a small injection of a steroid such as cortisone into the joint itself, or sometimes a small dose orally for a few days can help settle the acute arthritis down.
What most people want after having a couple of gout attacks - we know that their risk of chronic gout is high. We want to stop them from having the acute gout attacks, the joint damage, and the long-term problems. To stop gout, you really need to go on to another drug to reduce your uric acid levels so low that you will not have further gout attacks.
This is a condition that we can do a lot for, and really, people can be very involved with their own treatment and look after themselves a lot better.
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