How to treat gout?

Treatment

The severity of the symptoms and the extent of the disease determine how to treat gout. Treatment is not required if the disease is in the early stages of asymptomatic hyperuricemia. The purpose of treatment is to lessen pain, extend the time spent in remission, and, in the event of an acute attack, to lessen pain as quickly as possible. Corticosteroids and NSAIDs only treat the symptoms of hyperuricemia; they have no effect on the condition itself. After an acute gout attack, medications that lower the serum concentration of urate (allopurinol) are introduced. Finding the cause of hyperuricemia and treating the condition that caused it are crucial. One of the most typical causes of gout is obesity. Education about maintaining a healthy weight, avoiding foods high in purines, abstaining from alcohol, and drinking lots of water is crucial. After the initial acute attack, pharmacological therapy is started, and colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids are used.

Colchicine is a saffron alkaloid, once it was used far more, but today its use has decreased, mostly due to gastrointestinal side effects. Side effects are very common and include: vomiting, diarrhea, nausea, liver damage…

Non-steroidal anti-inflammatory drugs are: Acetylsalicylic acid, naproxen, ketoprofen, ibuprofen, and paracetamol… These medications won’t treat the underlying cause of the illness, but they will greatly assist in reducing pain during a gout attack. Non-steroidal anti-inflammatory medications work by inhibiting the cyclooxygenase enzyme’s activity. Cyclooxygenase enzyme inhibitors come in both selective and non-selective varieties. Non-selective cyclooxygenase inhibitors inhibit both COX-1 and COX-2 forms of the enzyme, whereas selective inhibitors inhibit just one form of the enzyme (COX-2). An enzyme called cyclooxygenase aids in the production of prostaglandins, which are responsible for the body’s inflammatory response. NSAIDs frequently cause the following side effects: diarrhea, heartburn, nausea, and vomiting. It is possible to administer the therapy locally in the event of joint swelling. On the market, gels come in a variety of forms that can be used locally. Gels containing ibuprofen, ketoprofen, and other similar medications can effectively treat pain without having any negative effects on the digestive system. ..

Inflammation is effectively reduced by corticosteroids. The adrenal gland produces natural corticosteroids. They have numerous side effects but are effective in lowering complaints. Diabetes and hypertension are made worse by a lack of corticosteroids. Long-term corticosteroid use can also cause diabetes, lowered immunity, etc. The medications betamethasone and prednisolone are an illustration of corticosteroids.

Allopurinol is the medication that combats the gout’s root cause. A xanthine oxidase inhibitor is allopurinol. To lower the likelihood of kidney stone formation when taking allopurinol, it is advised to drink a lot of water. There is evidence that allopuriol lowers the risk of myocardial infarction and lowers the level of urate in the blood. It is taken every day once. The majority of patients tolerate the drug well and can use it for long-term treatment. Of course, there are side effects, just like with any medication, and they include rash, liver and kidney damage, nausea, diarrhea, and nauseousness.

Prognosis

Gout is a chronic disease, but the prognosis is generally good. Of course, some people never develop a chronic form of the disease and remain asymptomatic, but this is a minority. People suffering from gout live a normal life by watching their diet and taking therapy. People who got sick before the age of 30 and people who did not diagnose the disease in time have a worse prognosis. Later diagnosis increases the possibility of cartilage and bone damage by uric acid salts and tophi. Since uric acid is excreted from the body through the kidneys, the risk of kidney stones is increased. In addition, it is considered that chronically high serum urates increase the overall cardiovascular risk (high blood pressure, damage to blood vessels…).

S.J.
23.09.2022.